HomeMy WebLinkAbout934 EVERGREEN PL - Building Permitst
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� o CITY OF COSTA MESA ,
, __ � BUILDING DIVISION '" �
� DEVELOPMENT SERVICES DEPARTMENT
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',y�- � PERMIT PERMITN BER
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698-01405
(714) 754-5273 • Fax (714) 75a-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
,lobAddress: 934 EVERGREEN PL
Suite:
Vicinity:
Parcel Nunmber: 42252108
Applicant: CRANK, JIM
Address:
Owner:
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BUILDING PERMIT
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Phone:� 774=548-5569 �
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fiERS�ROOFING CO
IAL WY
Status: ISSUED
Applied: 08/07/1998
Issued: 08/07/1998
; �'i � ' ` 'y�. ;� �' / � SCOPE OF PERMIT �
,� j-' � �,T/O'EXISTANDMST25iYRSHINGLES; � �� �,' '��r�,'��,
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FEE SUMMARY
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SETBACKS �. � �� � � >- _
MAINSTRUCTURE�Fiont �0-0 , Rear *0 0' "
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ACCESSORY Front , 0- 0 �--'; Rear - 0- 0
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PARKING Existinq: 0 Re uired: 0
NOTES:
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,;i, ;_ Calc Valuation: - ' , . � . Ss,2s9.00
` Claim Valuation l' ; $3,259.00
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Proposed: 0 . �
IEXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO 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 inspeetlone and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOH INSPECTIONS CALL: (714) 754-5626
WOI�,�i13' C9MIPENSATION DECLARATION:
I hereby ettirm untler penelty ot perjury ona ot the following tleclaretions:
� I h end will mainlain e ceRiticate of consent to selt-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, for the pertortnence of the
ork for which ihis permit is issued.
I �ave and will maintain workers' compenution insurence, es required by section 3700 of the Lebor Cotle, for the performance of Ihe work lor which this pertnit Is issued.
My workers' compensatio�surence wrrler end policy numDer ara: �� �� ��
Certier: �� • % � Policy Number:
(This sectlon neetl no�p/eted i! fhe permlf is ve/ued et one hundred dollers ($100) or less.)
❑ I certify thet in t¢���...pppeAortnance of the work forv�y�ch permit is iuued, I shell not employ any person in eny manner so as to become sub�ect to Ihe workers'
compensetlon IavY� d Califomla, and a ree � M(� sho d become su6�act to ihe workers' compensatlon provisions ol Sectlon 3700 of the Lebor Goda, I shell torthwith
comply wlth Ihese �r isions. �j
Applicem Signature: Date: � %— / �
WARNING PNLU O S RE WORKERS' C/JfdPENSATION COVERAGE IS UNUWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINPL PENALTIES AND CIVIL FINES UP TOONE HIINDRED
THOUSAND R ,000), IN ADDITION TO THE CQST OF COMPENSATION, DAM4GE5 AS PROVIDED f-0R IN SECTION 3]Ofi OF THE tABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS UECLARATION:
I hereby ettirm thet I am 'censed unQerprqyisyps er 9(commencing with Section 7000) ol Division 3 of the Business and�ofessions Cotle, end my license is in full
fome and eflect. Lic. M �'f U� �9 Class #
Contreclors Signeture: Date: � �2
CONSTRUCTIO DING AGENCV:
❑ I hereby eHirm ihat there is a consiruction lending agency for ihe Derfortnance of the work for which ihis pertnit is issuad. (Sec. 3097, Civil Code). �
Lenders Name: Lender's Address:
Signature:
OWNER-BUILDER DECLARA710NS:
oate:
I hereby atlirm ihat untler penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: My ciry or counry which requires a permit m construct, alter, impmve, demolish, or repair any structure, prior to its issuance, elso requires tha epplicant for such permit
to Ble e signed statament thet he or she is licensed pursuent to Ihe provislons of Ihe Conirectors License Lew (Chapter 9(commencing with Sectlon 7000) of Didsion 3 of Ihe
Business and Pmteulons Cotle) or Ihat he or she is exempt tharetrom entl Ihe basis tor Ihe allegetl exemption. Any violation oi Seciion 7031.5 Cy any applicant for e permit
sublecLs ihe epplicant to e civil penalry of not more than five hundred dollars ($500).):
❑ I, es owner oi ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl �he structure is not intendetl or oXered tor sale (Sec.
7044, Business and Protessions Cotle: Tha Contractors License Lew does not epply to an owner ot properry who builtls or improves thereon, entl who does such work
hlmseN or herseli or t�rough his or her ov.n employees, proNdetl that such improvements ere not intended or oHered tor sale. If, however, ihe building or improvement is
sold within ane year at completion, ihe owner-builtler will have the burden of proving ihat he or she did not build or improve for purpose of sale.).
� I, es owner af the properry, am EXCWSIVELY CONTRACTING WfTH LICENSED CONTRACTORS to consiruct ihe project (Sec. 7044, Busineu end Professions
Code: The wntrectors License Lew does not eppy to an owner of property who builds or improves Ihereon, antl who contrects tor such project wlih a comractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I em esempt under sec.
BuSinesS and ProfeSsionS Code For IhiS rea5on:
Signature:
Owner ID verified by tlrivers license. ❑ Yes ❑ No
VedBcatlon oi Ownership by (type oi document, I.e. - proparry tax bill or deed):
Driver's License No.
Date:
Expires:
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON:
❑ I hereby cenify thet no exwvatlon five (5) or more leet in depth imo which a person is required m tlescend, will De made in connection with work euthonzetl Dy this
pertnit, an0 ihat no building structure, scattolding, talsework, or tlemolition or tlismantling thereof, will be more than ihirry-six (36) feet hig�. (Chap. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Callfomia Atlministretive Code).
❑ As owner-bullder, I will not employ anyone to do work which woultl require a pertnit irom the Division ot Intlustrial Safery, es noted ebove, unless such person has e
pertni� to do such work from tha division.
SipnaWre: Date:
DiWsion ot Indusirial Sefery Permit Number:
CERTIFlCATE OF CAMPLIIWCE AND AIITHORVATION OF ENTRY: I certity under penalty ot perjury that I have reed Ihis application antl state ihat Ihe infortna�ion given is
correct I egree to comply with all stata laws and ciry ordinences relating to building construction, and authonze representatives of the Ciry oi Costa Mesa lo enter upon t�e
above�scribed property for inspection purposes. I agree not to occupy or ellow occupancy of any building authonzed by this permit until tinal inspection.
1616
7288
200
201
202
203
204
2uBd6
INSGECTION TYPE
Fixed System Final Fire Prevention
Pool Spa Finel
Finel Re-Root
Final BIocWReteining Wall
Finel Factory Fire Place
Final Sign
Final Demolition
� I��
�' 7-���
Date
COUEt INSPELTIONfYPE
206 Final Mechenicel
208 Final Plumbing
210 Final Eleciriwl
212 Final Fire Prevention
220 Finel Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
PAB II�AlS
, ,UBJECT PROPERTY INFORMAT'fi`'
1) Property: 934 EVERGREEN PL, COSTA MESA CA 92627-4136 C011
APN: 422-521-08
County: ORANGE, CA Tax Rate Area: 15006
Census: 636.01 Prop Tax: $1,312.40
Map Pg: 31-62 Delinq Tax Yr:
New Pg: 888-G3 Exemptions: HOMEOWNER
Phone: 508/433-9747 �
Owner: DWYER RICHARD A& DOROTHY J �
�
�_�__ -- �
Mail: 6 PROVINCE $T;pEPPERELL MA 14631-734
SALES INFORMATION
LAST SALE
Transfer Date: OS/25/89
Sale Price/Type:
Document #:
Document Type:
1 st TD/Type:
Finance:
Juniar TD's:
Lender:
277331
GRANT DEED
$115,000 VARIABLE
PRIOR SALE
01/80
$110,000 VERIFIED
Seller: DWYER RICHARD A
Title Company: CALIFORNIA COUNTIES TITLE CO.
Transfer info:
SITE INFORMATION
Improve Type: DETACHED
Zoning:
County Use: 1
Bldg Class:
Flood Panel: 06059C-0046E
Phys Chars:
Legal:
Comments:
Lot Size:
Lot Area:
Parking:
Park Spaces:
Site Influence:
A0.24
10,500
ATTACHED
2
VIEW
Use: SFR
Total Value: $111,528
Land Value: $54,102
Imprv Value: $57,426
Assd Yr: 1997
% Improved: 51%
IMPROVEMENTS
Bldg/Liv Area: 2,684
# Units:
# Bldgs:
# Stories: 1
$/S F:
Yrblt/Eff: 54
Total Rms: 7
Bedrms: 4
Baths(F/H): 1 2
Fireplace: 1
Pool:
Bsmt Area:
Construct: FRAME
Flooring:
Air Cond:
Heat Type: WALL FURNACE
Quality: AVERAGE
Condition: GOOD
Style: BUNGALOW
Other Rooms: FAMILY ROOM
COMPOSITION SHINGLE ROOF COVER;STUCCO EXTERIOR;PUB�IC WATER;PUBLIC
SEWER;FENCE;GOOD FUNCTIONAL UTILITY;RANGE OVEN;DISHWASHER;DISPOSAL;RANGE HOOD;
L256 TR1712/POR OF LOT
Copyright O 1996-97 Experian Page: 1 of 1
SUBJECT PROPERTYINFORMA� V
1) Pr erty: , STA MESA CA 92627 �
APN: 422521
Caunty: �ORANGE, CA Tax Rate Area: 15006
Census: 637.00 Prop Tax:
Map Pg: 31-B2 Detinq Tax Yr:
New Pg: 888-G3 , - Exemptions:
Pnone:
Owner: CITY OF COST
Mail: PO BOX 1200; COSTA MESA CA 92628-1200
SALES INFORMATION
LAST SALE
Transfer Date: 11/26/79
5ate Price/Type:
pocument #:
pocument Type:
1 st TDlType:
Finance:
Junior TD's:
4ender:
Seller:
Title Company:
Transfer Info:
1340801292
SI7E INFORMATION
Improve Type:
Zoning:
County Use: 8
Bldg Class:
Flood Panel: 06059C-0046E
Phys Chars:
Legal:
Comments:
PRIOR SALE
Lot Size:
Lot Area:
Parking:
Park Spaces:
Site Influence:
L256 TR1712/POR OF LOT
Use:
Total Value: 5673
Land Value: i6T3
Imprv Value:
Assd Yr: 1997
°h Improved:
Bldg/Liv Area:
# Units:
# Bldgs:
# Stories:
$/SF:
YrbIVEff:
Total Rms:
Bedrms:
Baths(F/H):
Fireplace:
Pool:
Bsmt Area:
Construct:
Flooring:
Air Cond:
Heat Type:
Quality:
Condition:
Style:
Other Rooms:
a
Copyright OO 1996-97 Experian Page: 1 of 1
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CITI' OF COSTA MESr�
CALIFORNIA 92626 P.O. BOX 1200
FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETV
May 16, 1975
Mrs. Pauline B. Cheney
36856 Balch Park Drive
Route 2, Box 147
Springville, California 93265
RE: Property at-934 Evergreen Place
Dear Mrs. Cheney:
We wrote you in regard to the above noted address on April 3,
1973 and required that an illegal structure be removed within
thirty (30) days. As of this date, the structure still remains.
If the structure still._remains on-May 26, 1975, we shall request
that the City Attorney file an action to require compliance.
Sincerely,
/�
RICHARD HANHART
Building Safety Director
RH/ar
Registered Letter.
� � ���1
���� �
G�-� � -��r t�� t
`���-�--� ` ,�, �V� C
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� V/
N ��GG -1�Y �Y ` �1 � ���.
rG ro, �'�c? �Gf <��f" '
,�� %� ;
.
��� U�.�'—CL �i,� �„�— Ct ct �./�
C/v / �'�' �� �-�"�"�.
✓r�'��% � � ��� �� ,
.�' %�. c 7� , �c-rt!%°-�i`�-(-���
! .��� �.��,
PflOJEL7�A00flE5S: ; C�4 ;VERGRF.LN PL�
OWNEfl'SNFME: T-��Y�.� �Z�:3�D A.
aooneti pwy�� DOROTHY 3
- , 9s4 EC��RGREEN PL
� : COSTA ;!ESA,CA 92627
APCMIENGMEEfl: � � 6 — 5 � � 5
AUONE55:
HEG.NO.:
uxir:
UNIT:
PEflMITTEE: RICHARU ijkY�R (7i4}646-9059
aooness: g34 EVERGRE£NPI�
r t� CA 9267.7
LICENSEO CONTHACTOfl �ECNNRTION: I here�y affirm Iha� I am IicenSeU untler provisions of Chapter 9(commencing wi�h Sectian
7000) of �ivision 3 0l Ihe Business an0 Protessions Code, antl my license is in tull brce antl e��eci.
CITY LIC.: STRTE LIC.: C1R55:
�ate: �Signature'.
WOBREBS' COMPENSRTION OECLAflATION: I hereby a��irm Ihat I have a cetlilica�e oi consent �o sell�insure or a cetlilica�e of Workers'
Compensation Insurance, ar a cetldie0 copy Ihereof (Sec�ion 3800. Lab. C).
PO�ICY NO.: EXP. DFTE: '
COMPFNY:
U Cetlilietl copy is �ere6y fumishetl. ❑ Certitietl copy is filed wi�h Ihe cily Builtling Oivisian.
ate', APPltcant �
1(EMPTION FPOM WOBREXS' COMPENSIITION DECUBRTION: (This section neetl not be complete� if Ihe permi� is br ane huMreE (5700) or less�.
I cenily ��al in �he pedormance of �he work lor which ��is.permi� is issuetl. I shall noi employ any person in any manner so as Io become
sublec� �o I�e Workers' Compensa�ion Laws of Calilornia.
Oa�e: SignaWre'.
NOTICE: I�. a�ler making Ihis aedaration, you shoultl become suhlecl to ��e Workers' Compensa�ion pmvisions of the Labor
Cotle. you must lotlhwilh comply wi�h such pmvisiuns or Ihis Dermi� shall �e tleemeG revoked.
CONSiBOCTION LENOING AGENCY: I hereby al�irm thal ��ere is a canslmc�ion lending agency lor ��e pedormance o� [he work for
which ihis permi� is issuea (Seciion 3�97, Civ. C�. •
LENOEfl:
noosess:
OWNEF 6WLOEfl OECLAflATION: I hereby atlirm that I am exemp� �mm �he Con�racbrs' Staie License Law �or lhe following reason
(Seciion 7031.5 Business and Pro�essional Code'. Any ci�y ol coun�y which repuires a permi� �o constmc�. al�er, impmve, tlemalish, or
repair any s�mc�ure, priar Io i�s issuance. also re0uires Ihe applicani �or such permit �o file a signetl statement �ha1 he/she is licensetl
oursuam Io ihe o�ovisions oi Ihe Contracmrs' Slale License Law (Chao�er 9lcommencing with Section 7000) of oivision 3 of the Business
ana Pmlessions Code) or Iha� he/she is exempt therefmm antl �he basis for ��e allege0 exemplion. Fny viola�ion ol Seciion 7031.5 Uy
any applicant for a permi� sublec�s the applicant ro a civil Denalty oi not more ihan five huntlretl Goilars (E500).
I, as owner oi t�e pmpetly or my employees wit� wages as Iheir sole campensation, will Ao Ihe work, antl the
0 slmclure is nol inlendetl or onered lor sale (Seciion 7044. Business and Protessional Catle: The Coniractors State License Law
Uoes no� aOPly to an owner of a pmpetly who builds or improves Ihereon, antl who tloes such work himself/herself or lhroug�
' his or her own employees,.proviaetl t�al suc� impmvemems are not inten0etl or otlerea for sale. Ii, however t�e �uiltling or
impmvemenl is 5010 wi�hin one year o� completion. �he owner will have �he Ourtlen of pmving he/she did no� bui10 0� impwve
-lar the purpose ol sale�. ,
I, as owner ol Ihe pmperty, am exclusivety coniracling wilh Iicen5e0 conVactors to canstmci Ihe Dmle�� (Sec�ion 7044, Business
❑ antl Pmlessions Code'. The Conirac�ors' Slale License Law Ooes noi aDPly Io an owner ol pmpeny who UuilOs or improves Ihereon
antl who coniracts for such D�olec�s wiih a contrac�or�s) license pursuanl �o �he ConVac�ors' Sta�e License Law). I am aware
Ihat proai af Iheir Worker's Compensaiion insurance shoultl be pmvitled to me.
� I am exemp� under Seclion: B. 8 P.
I0f 1�15 fQd50111 �
Date: � � Owner. b
I tlo herebY �artily I�at I am aware o1 and understand Ihe reqmremen�s af Califomia Heal�h antl Safery Cotle Seciions 25505, 533, ane
25534 an4lhai I or any fulure builAmq occu0ant will/will no� �circle one) neea lo comply wilh saitl s�ate co0es antl �he requiremenis �or a
permi� far conslmclion ar motlilication imm ihe Fir Ouah�y Managemenl �i5lricL Fesiaen�ial cons�mction applications are exemp� imm
IheSe provl5ion5` .
Date: AOP6wnt:
I hereby cerufy ihat I have reatl t�is applicatia nd s�aie ihat �he a ' formation is correct. I agree to comply with all city antl co nty
oi0inanw5 and slatelawsrelatingto builtling nstmction re y au zerepresen�a�ives o�thi r upon��e above-me netl
pmpe�ry Ia� ins0ec�ion pu�pOseS.
Oale: �/ Z��R� SignaWre: .
Oriver s License or Social Securily p: �.{� �
i6aLafi White—Builaing�. Green—Co�e Enlorcemenf Canary—Npplicanl; Pink-Revenue; Goltlenrotl—Assessor
CITY UF COSTA MESA - BUILDING PE�NTT PERM i�Q: 3. 053`.i'7`_
PERMIT NO: B OSJ575 PLA2. CHECIS ��0; 0325U-yl S GOVT: ;v SiJPP: 't1
CONSTRiJCTIOh TYPE: PERMIT ?YPE; STR P�RPOSE: �DA
JG� DnSCRIFTIUN ; 550SF 1fS" RAIS'ED UECR, 200SF OFEN LATiIC SQ FT: 700,
CLAI3✓ VALuE: 3,000.00 CALC-VALU�: 3,260,U0 GROUP OCC: R-3 /
CO�IMEN'TS: PATIO COVER OVF'R AEC.K
��-K IF-U iE�1: x� �k �Y, k� �k �N if �Y.� �Yr iC �'F. 3(� 3i iE if i( -)f� �E dF #:h �1E �k iE 1P'rc iE-bt iF iE �X-i4 IF ie if fi 3E �K��Fjf ic dt ii �7E 3E # if-iE iE aE -If iE;i �M 3E If if ff dE��R �1f �!E 9F �%�:7F �Jf iF 1=9c 3E # If �%
Z.O N 3 N G R E� U I R F M E N'T S .
S E T H A C iC S
----------- MASN BGII.,DTNC -------�--- -------- ACCESSORY BULT.D'SNG •--�---�-----
FRNi: FT IN R�`AR: 24 FT IN FRNT: FT �.N REAR; Fi IN
LEFT: 46 rT IN RGffT: FT IN iEFT,: FT 7N RGkT: FT :iN
PAi2zSING RE�; PROV• PARCEL• 4225?.i08 ZNE: R1 REF Nb;
Pi�ANNlNG NUTES;• iATTICE PAT�O COVEft TO BE CONST UVER DECH ATi "f0 krAR Or EH
% SFD - DECK 0-i8" ABOVE GRADE, HOTH +10' F'/ REAR FL £<;,,�I..UFF •
f:..k.Y...l't�if 3F �%� %..y:..i; i[� iE i6 �'f.�%jf 3f if ?'e`J,' 1E lE iE # 1.' #�4 IF�fi �IE �if %� # if 1E if �k % Yi �% Y. �k�N �l'r �K i(� di dF lE �1E li Y iE ii �N �!F if �i iE �Y. 3e �1� # iF �}i 1t?f #.�iC x�IF �'r. 'r' %.X• �iF 1F.Y- iE.
D E V E L O:P M E N T 5 E R V I C E S R E Q ii I R E.M T' N;;.T S
ZONING APPROVED BX '' _ �'`1�1�- _ DA'I'E; ��%��_
BUIT�iJING APPROVED HY ; lL� DATE; �12.l�1��_
l
APPLICA't'!ON 75S[TED SY: �-�� DA`I'E: �1 ��_I
iE�X'#X�4rrE9E��k�kiEY�kiE�ridfN�if�k�K-iE�x�:�E�fF�xie- ' x- �x � ��+ri x��T�:vr&�.+. 7'i-#3fiE�kiE}#�?f9Eii wR�x�tii�):�-1'<
if ��E iE �E �k )c if �)f� iE N �: 3F �7F �4 i!� iE �iF�K-�k iF �K i: �� �E �li� 3E f �34 -Ie 1e iF df �k �IE fC- �}� �le �Y i(�# �k 9f tiE �K �%#+E iEY 4 14 iE �X �if �k ): 9F i( 7i-i' IEdE � �'{ ;{ iF �?E �Y. R iE dE �lf �N��%i; �ri �%�E #
I�EGA.LI7.ATION:N F E E 5 U M M�l R Y STRi7CaIJRAF, SEGME?�A:Y
HLi7G PM'T PI,LMBIN:; EiEC:TRIC MECNANZC F.IRE SMTP/RES; GF.:4nItvG
P£RMIT 63.G0 50'
SMTI� /AION'-R'r'.S
Ui,AN 40,95 ;_
I.SStJE FEE �
9liILU:i�G-DIV-> PER�I1' ISSUE ?LAN-CHECK TOTAi� PAID %. D'uE
i'OT'ALS----> 6J.50 O,OU 70,95 iO4.45 109,55 I. ,OU
RcV�NiJE DIC�ISION T(aTAL.s--> COLLECTED: 104.45 UV"c:�I5iiORT; ,00
BLDG PNT PLUMBING ELECT'RIC NECFiA1�IC FIRE S�:IF�/1GT GRADIi�G PLAI�-C3ECY:
63.00 ,50 :'�;. 40,95
f�e #;i� 1'r M� 3c %ii� i: ii� �k �%� 34 # ii� ii� ?r ib #f� 3i� i'r iF ai ii� i%. V� if ># iE ie if 3F -'r' d'r }!� i4 iE :r-�f ii� 3E iF i!� iE iE �1F �k ii-'f �li� Y i: ii?} if if ±c 3c Y 3F � lY {(� �3'r if ?k ��,i'i-ie i4 �'v 3i if� i%3E±4 iE
I;ti D I V I D[3 A L F E E B R E A K D O W N ��
TYPE �TY , U � S C R Z P'I' I O N UNZT COST
SF'R :00 RES-PP.TIO COVcR-PG57' 6 TREI,LT� 13.80
5FR 500 ALTER 3Y VAI,t)r^. �ESIDENTIAL NU70NE I.00
END QF 'r"EE:,
�OTAL COST
�o", 9
..,760,UU
SUO,UU
Ill QGO?`6h3-CQ�1956dg .'If C�'Y' 1t�;,4g,
DATE: 0$/26/9i iiC4. 1i:'s?
CONSTRUCTION AND PLANNING � - � POO ,�.. � � �
APPgnVALS Permit # " Date � Inspector pppROVALS Permit # Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. $oilPipe-Undrgrnd. 53.�SteelReinforcement
3. Electrical Conduit UtilityUndrgrnd. � 54. Forms � �
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding� -.
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings ' �_��-q �� u.- 58. Electrical Conduit-Undrgrnd.
8. Foundation . 59. Gas-Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor SYstem - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final _
12. Sewer Cap - 63. lieater & Ven4�Final �
13. Roof Drains 64. � Plumbing System - Final
14. Rough Plumbing 65. E�ectrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ��
18. Rough Electriwl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Hea[ing & Air Conditioning - FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas O Oil
23. Gas Pipe�Rough & Test 72. Underground Fl�sh
24. Roof Framing , 73. Undergrnd. Storage Tank � Gas ❑ Oii
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical -
27. Frame and Flashing -_q � 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning .
35. Final Gas Pipe�Test
36. Hood or Canopy t
.�
37. Final Factory Fireplace
38. Final Plumbing �� -,. ,
39. Water Service-Final . '
40. Gas Service-Final
41. Solar pomesticFinal _ •
42. Backflow Preventer "
43. Backflow Irrigation �
44. Landscape IrriGation System . . .
45. So�nd Attenuation .
46. Handicap Regulations ,
47. FINAL STRUCTURE & 9UILDING „l�Cjl lp(,�� - , ,�i� Q /-'� .�.
•x�oi- --ac�-c�pc
48. FINALPLANNING . �
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Cn ,
51. CERTIFICATE OF OCCUPANCY
No. Date .
20u�s.R00F CONNECTION
DETAILS
CONT.
LEOGER
10 BLOCK
RqptER
�I/2�� DIA. X S�� LAG �SCR.��
AT 32�� O.C. �-;;�. ��
T : : .
�s.,-,,
/ r .r,' �
�
,;, ; {.
DETAIL I - "' '
i' .� �; ;,�;; ,, _
�, .- - -0
� -�,w�;�=?. `�`'
� ��:;' >;° �° .^` ?
, �> >• �� :
1 rt � s, . , g\_� ;,
y c.
- ,.� �, � . ,
. ,� `:�% �->; �'..'> s�;(.
CONT. =�-. `.
LEDGER -„ -��
� >'�RAI
:>, ��
- '_, ;
3/$°� D I
AT��(�
DETAIL
DES7ECpPD�TI'
smvtcEs n��ar
BUIIAING SAFEi1' DI\lISION
OWNER: �.is-N�R.D ��YefL
ADDRESS� g�4 c\JC2C'TR-EE-iJ �Z.
CONTRACTOR: ��
ADDRESS:
:�' �.
� .�.
q' �b, P
��.
, ��'; ,p���4!��0
" ;r�.
'o
`��; ;;�,"�''
'„'_ ::> ;\,;
,
.�
� . _ 2.'!s6" ,
�� .
: /i`:-'��� ;�� ,1
S��:L�AG"�SCR.��; �' :�
�s ' ,:r
. . '�. -.� ��" � ��
. , �a"�� ,iPrY
-'� `'/ 2"x8;�
\'y�;*../? ,D`�J
IO�e�OR LIGHT WEIGHT RO
ONLY CONNECTION DETAI
X FACIA-MIN.REO.
RAFTER
APPROVEO METPL
HANGER
DETAIL 3
ERS
OR PATIO
, c' $Pnia
� y�_6��
8' -0 ��
\*� 6�_6��
:� 6'-Q�;
.' lac�:n��
12" ' �A..16�_6��
��'"� i
16:i ;:%».,'` 14' -6"
l�i"' °t;ti'/12'-0��
32"( ��'�� 10'-6"
48"°�•, � 8' -0"
24': "' 15' -6"
32'/ 13'-6"
4'8" 11' -6"
24" 17'-0"
32" 15'-0"
,��� ,,.�_���
4'�x8^ 24" 21'-0"
32" 19'-0"
36" 18'-0"
48" 16'-0"
4"x10" 32" 22'-0"
36" 21'-0"
48" 20'-0"
72" 17'-0"
PATIO COVER
TYP. PLANS
DATE: �"1�/q
PHONE� 6`t 6-�ios9
LIC. N0.
PHONE:
RAFTERS
LIGHT WEIGHT ROOF COVER OF
LATH, FIBERGLASS, ALUM.
SIZE SPACING SPAN
2"x4" 16"O.C. 9'-6"
24�� 8�_���
32" 6'-6"
48" S'-6"
2"x6" 16" 16'-6"
24" 14'-6"
32��. 12� _���
48" 10'-0"
2"x8" 24" 19'-0"
32" 15'-6"
48" 13'-6"
�ax•�i��y
LICHT WEIGHT ROOF ONLY
SIZE POST SPACING
4x4 6'-0"
4x6 9'-0"
4x6 12'-0"
4x10 15'-0"
CARPORT, PORCN OR PATIO
SIZE POST SPACING
4x4 S'-0"
4x6 8'-0"
4x8 10'-0"
4x10 12'-6"
APPROVEp FOR
BUILDINC PERMIT
By Date
C@1ERAL NOTES:
1. These plans must be
kept on the job a[
eii time during
construction.
2. All framing to be
Douglas Fir N4 y
grade minimum.
3.. Raftets may not
attach to facia ex-
cept for 1016nroofs
as shovn on detail
20Tbsroofs muet use
a continuous ledger
attached as shocm
on details #18#2.
4, Light Weight roofs
may attach to facia
for 14' span max.,
spans over 14 must
use a continuous
ledger as shown in
detail 113.
��u�yp(�qImp
l91�J�1l�ICJ ILUl9��;
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NOTE� SHOW AND DIMENSION PROPOSED
PATIO COVER AND YARD AREAS
*
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PLOT PLAN
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FON POST- BEAM
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26 GA. G.I. FLASMING
WOOD FLOOR
CONSTRUCTION
SIDE ELEVATION
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Caller s Name ¢
CITV OF COSTA MESA
SERVICE REQUEST & PUBLIC ASSISTANCE FORM
. n,y,i.(;(�— Date � —/�^°J
�- ���� -
, Z
Time
Address Phone
Nature of Request: (location, type, severity)
q.�� �,��� — ����,�,��� o � ✓����—
� � �— �' @��ss�� �2oP Li�,e--
�.�o ��21� � P ;
��/ ���n �� �'`
Referred to
Person Receiving Call ��
�
C/�L`��4%� !a ��lal�• �/��
Call back �
Service Only �
Information Only �
PflOJECTROUPESS: 934 EVERGREEN PL
OWNEH'SNRME:RICHARD A, DWYER
aooRess:939 EVERGREEN PL
COSTA MESA
CA 92627
AflCNIENGINEEfl: � 7 S�i � 6 4 G— J O S 9 qEG.NO.:
p00flE5S:
UNIT:
UNIT:
PEflMITTEE: RICHARD A: llWYER ( 714 ) 646-9059
, _.
aooness: g34 EVERGREEN PL
COSTA MESA CA 92627
LICENSEO CONTPACTOP DECIABATION: I �ereby attirm ihai I am Iicense0 unEer provisions o� Chapter 9(�ommencing wil� Seclion
7000� ol OiNsion 3 0� I�e Business antl Pm�essions Cotle. and my license is in �ull force and effec�.
CITY LIC.: STATE LIC.: CLASS:
�ale: Signaiure:
WOflNEBS' COMPENSATION OECIABATION: I hereby aflirm �hal I �ave a cetlifica�e of consent �o sel4insure or a cetlifica�e of WorkeK
Compensaiion Insurance, or a cerniietl copy therea� (Seciion 3800. LaO, C),
POLICY NO.: E%P. ORTE:
COMPpNY:
❑ Cetlilied copy is here�y �umished. ❑ Cerlilie0 capY is IileA wi�h the ciry Building �ivision.
9a�e: FpplicanL
cXEMPTION FPOM WOBKEPS' COMPENSIITION OECLGBATION: s seciian ,ea no� be comple�ed' ie pem I's for one huntlred (5100) or less).
� I re�ify t�at in Ihe pedormance oi ihe work for which �hi ermit is iss . I shall no mpV �,pny Derson i any manner so as �o become
su�jeclt�o he Work 5' Compensalion Laws o� Calilomi
Daie'. ` �� Signa�ure'.
N ICE: It, fler making I�is Oedara�ian, yau s�oultl Uecome suble�t lo the WOBers' ComDensa�ion pr sions of ihe Labor
Code, you must lotlhwi�h comply wi�h such pmvisions or �his permit s�all be tleemed revoked.
CONSTBOCTION LENOING AGENCY: I hereby aflirm tha� there is a consimclion lending agency for �he pedormance o� Ue wo�k for
whic� Ihis permii is i=.suetl (Sec�ion 3097. Civ. C).
LENOEfl:
aoosess:
OWNEfl BUILDEP OECLANATION: I Aereby a��irm thal I am exempl Iwm Ihe ConVactors' Staie License Law for �he following reason
(Sec�ion 703t5 Busmess antl Pmiessional Code: Any ci�y of counly which requires a Dermi� to consimc4 al�er, impmve, demolish, ar
repair any s�mc�ure. Drior to its issuance. also reQuires Ihe applicani for such permit �o �ile a signed slafemeni lha� he/she is Iicense0
pursuanl to Ihe pmvisions ol the Comracmrs' Slate License Law (C�apter 9(commencing wi�A Section 7000) o� Oivision 3 0� �he Business
and Pm�essions Code� or Ihal he/she is erempl �here�mm anJ the basis for �he allegetl exemption. Any viola�ion o� Section 7037.5 by
any applicani for a permi� suble��s �he applicant �o a civil penalry of no� more than tive huntlretl tlollars �5500�.
I. as owner ai me o�ooeny ar my employees wi�h wages as �heir sole campensation, will Ao Ihe work, an0 ��e
❑ slmclureis notinlen�ee orafleretl larsale (Sec�ion 7044, Business antl Pm�essionalCode: The Conlraclor5' Slaie License Law
does not appty to an owner o� a pwpehy wfw builtls or impmves Ihereon, ana who tloes such work himsel�lherself or �hmugh
his or her own employees. pmvitled Ihat such impmvemen�s are no� iniendetl or o��eretl lor sale. If, however [he huil0ing or
, impmvemen� is sala wi�hin one year ol completion, �he owner will have Ihe burden ol pmving he/she aid nat hui10 or imD�ove
lor Ihe Durpose ol sale�.
I, as ownerol Ihe pmDeM1y, am exclusivety coniracling wi�h licensed wnlraciors lo constmc� �he pmlec� (Sec�ion 7044, Business
❑ an� Protessons Cotle: The ConUaclors' S�ate license Law tloes no� apDty to an owner al pmpetly who builds ar impmves �hereon
and who con�rac�s tor suc� pmlecls wi�h a conVaclor(s�license pur5uanlio Ihe ConVac�ors' Slaie �icense Law�.l am aware
Ihai Dmol ol lheir Worker's Compen5aiion insurance shoultl Ge pmvided Io me.
.� I am exempl unaer Section'H P-� 0 4 4 B. 8 P. C.
mr mis reason: ALL WOkK BY OWNE
Oa�e'. ���i,J Owner ,
I tlo here�y cently Ihat I am aware oi and untlerstana Ihe requiremenls o� Calilornia Heal�h an0 Safety Cotle Sections 255Q5, 533, an0
25534 antl ��ai I or any future building occupanl will/will not (circle one) need lo comply wilh saitl sta[e co0e5 antl Ihe requiremen�s for a
permit lor conslmtlion or motlJicaiion imm I�e Air Ouality Managemen� �istricL Resitlen�ial consimc�ian apDlicaiions are exempt �rom
Ihese pmvisions.
Oale: Ap0licanl:
I here0y wridy I�at I have reaOlhis applicaiion and sla�e Ihal ve inlor �tion is correcL I agree ta comply wiih all city antl counry
ortlinances and slatelaws relaling�o builaing consimdion ere�y aulhorize presen�atives oli � iB'�TiliB lerupanlhe abave-men�ianetl
properiy faiinspection purposes.
Oate: Signawre:
�river's License or Social Security
�6aLd6 While—Bmltling�, Green—Coae Enlorcement�. Canary—ApplsanC Pmk—Revanue', GOltlenroC—Assessor
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: B 060610
PERMIT NO: B 060810 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; INSTALL FACTORY FIREPLACE SQ FT; 500
CLAIM VALUE; 500.00 CALC—VALUE: 500,00 GROUP OCC: R-3 /
COMMENTS: THE "TEMCO" FACTORY FIREPLACE ICBO#3195
**�t***+t�t�t***�r�r**�t*�t�t**�r�r*�r*�r��r�r+t�***�r*�r�*�r�r****x �t*���rx *��t�r�r�t*�r*�t*��t****�r**�r*�t�r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- 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; 42252106 ZNE; REF NO;
PLANNING Nt5TE5>
%
it iF iFiE iE 1E ik �f ik �FiE iF if ik ik iE iF iF iE iF iF iF if ik iE 1k if ik 1k if iE if iF if iE iE iE iE iF 1k iF fE 1E �E it iF iE iF 1E iE if i! 3f iE if iElE iF iF iF iF iE iE iElE iE iE iF 3F ik jE1F iF 1E iE �E If iF if
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 DATE;
BUILDING APPROVED HY ; _ _ DATE; _____
APPLICATION ISSUED BY; ' / !� DATE:
1EiEififlFiFlEilitlEiFitlEiE1ElEi!*iEiE!!iE iFlfiEiElEiFitiEdFiE . .. 1Fif
I kkiEkkiFiF�EifiEiF�flEifiF�fiF3EitklEiEk3lif3l1F�E1EiFiFiFifiFiFk3EiFiFiEif ikkkififiEiFifiElEiFiEiEitiFiF�fifififdEiFik3E1E�E1EiflFiFiFikitlE�kiE
ILEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 15,00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15.50 0.00 0.00 15,50 15,50 .00
REVENUE DIVISION TOTALS--> COLLECTED; 15,50 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRAUING PLAN—CHECK
15.00 .50
if if ik jf i! iF iE iE �k i! if 1t if ik iF iF jF i! if iF if iF if 1F if 1f if iE if if i! iE i! i! iE iF iE if iE iE iF i! 1E iF if iE 1E iE i! iE if if iE ik if iF 3k 3E iE iE iF �F iEif iE iE iE 1E 1Ei! iF iP if if iE iF �E iElF
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 C1NIT COST TOTAL COST
SFR 500 ALTER HY VALOE I�ESIDENTIAL NOZONE
�,END OF FEES
�.. ,
i i
EXPIRED
I ot@ Irspectiau
o,� �/�� s�e - _—
�.' � . . '� ,'.:
1,00 500,00
',C, _ , ' '_ ' .
CONSTRUCTION AND PLANtVING � POOL & SPA� �
APPROVALS Permit #� Date Inspe.ctor APPROVALS Permit # Date Inspeccor
1. Temporary Electrical Service or Pole . _' S2. Pool & Equipment Location
2„ SQiLPipe-Undrgrnd. � 53. Steel Reinforcemznt � �
3. EMctrical Conduif Uei�iry•Undrgrnd. 54. Forms ' '
4. Elecirical Conduit-Undrgrnd. 55. Electrical Bonding -
� 5. Siee4 Reintorcement� 56. Rough Ptumbing & P�essure Test _ . -
�6. El�ctrical UFER Grnti. 57. APPROVA� TO COVER�GUNtTE
��7�..Footings :i.� , 58. Electrical Conduit�Undrgrnd. •
�' 8: �oundation � � ' 59. Gas Pipe, O Undrgrnd., Test � �
� 9. Water Pipe-Undrgrpd. , 60. Backwash Lines, P-Trap, O Undrgrnd. _ ;
70. Structural Floor System 65. APPROVAL TO DECK . • -�
11. Property Sewer LinA & House Connection � 62. Backwash & ReceptorFinal - �
12. Sewer Cap . � 63. Heater & Vent-Final �.
13. Roof Drains ._ 64. Plumbing System - Final � i
14. Rough Plumbing � � 65. Electrical-Final . .+
15. Rough Eiectrica%Co�duit �- 66. SoiarSystem•Final � '
i
16. Rough Electric�4Viring + 67. Pencing & Access Approvat ' �
iJ. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
18. Rough Elect�icaGT Bar Ceiiing 69. POOL/SPA SYSTEMS FINAL •
79. Rough Hea[ing & Av Conditioning - �;.; _ ,_p�R DEPT. EQUIREMENY
�, . �.
20. �Rough FactoS"y F jeplace � � r - < " " i ,. - ;APPRQVAISj ' Perrcut # �
27. Duaz, in=5tructur"e' � " " ;,• i' _ ' ,_'7D. UndergrSund3Hydro ' ,
22. pucts, Ventilatin �. , ' - ;'._ ��'� �'
9, •� .; TJt. Product�'jpingOGas ❑Oil .
23. Gas� Pipe-Rough & Tesc � ��� ��� _ - �=+' '` ,�72. Undergrourid,FlyFti � ' , a•,
24. floofFraming - � >' , '� `.." ;73.:Undergrnd�Storaqe:TankClGas ❑Oii .
25. Roof Sheathing = . � + � - � � 74: Overhead Hydro - �
�
26. J-Bar Cejlin (Strudturaq & �Monocoat ' ' � �� ' � - �-n -.
9 75.� Dry Chemical �� d
t _
27. Frameand Flashii7g. _ _ - • ' 76. Dry Standpipe � - � ' ' �
r r
28. Lat#fiing�& Sidin9,' - - - - . ' ��,.. 77.-PIXED SYS3EM-F�NAI,� - .`
29. Insulatian � � '+ • " � - 78: -FIRE PREV. FINAI " � " t
30. DrywallNailing � :.. .�� , � HEALTH.DEPT;F�EQUIREMENT ? '
31. Plaster Btown�Coar� , + � !� ��" + �79. FINAL INSPECTION � .
, ,-�_
F i` `� ; •`B0. `f00O CERTIFICATE IS$UED, .
� 32. ElecvicAi Pov✓er Me erFinal' �`�;
� c � - �
33.-�inal Electric 7 z � � '< � Notes: =�: � 1+
'34.-.Final Heating& Air�Conditioning � ' ' j* ' ti .� � ` � -
35." Final Gas Pipe-Test�� `; � - i � �" • ' =c. -'
36. Hood of:Canopy' ' ' �' �' �� `��= ` �
� c i% T' '.G �
�" � .i �_
_37. Finai.Factory Fireplace c - . ' / I: � �� ..
�
38. Final Plumbing _ ` ` 1 ? , ' �
'4• c
' 39. Water Service-Fin�dl, - � , � , � . �
�40. Gas Service•F�nal � t � •� � ! � ' - -
41. Solar pomesticFinai � . - , "' ' ! � �
� - '
42. Backflow Preventer� �`' - � � -
r
43. Backflow Irrigation ' . � �� -
•44. LandscapelrtipationSystem- - � • r'� � - . •�- - � ' �� --
_ ,
� 45. Sound Attepuation ` . ' + y . . �+ t • -
46. HandicapRegulations : - - � x �? ��_ ` •
� I � r �
47. FINAL STRUCTUgE & BUILDING ' � ; : �'. ; '
48.�FIN,4LPLANNING • I
�49. Electric Release to Edison " i �� �.
' '.
`,50. Gas-.Release to Southern Cal(fornia Gas Co > � ' �< �- . • -. � �
x �
51. CERTIFICATE OF OCCUPANCY • _ . - "
No. Date
PFOJECTAODPESS: C�'34 EVERGREEN PL
OWNEH'SNFME:RICHARD A, DWYER
ADOPESS:(j34 EVERGREEN PL
COSTA MESA
CA 92627
RflCNIENGINEEN: � 71 4� 6 4 6' 9 � 5 9
nooacss:
flEG.NO.:
UNIT:
uxir:
PEflMITTEE:RICHARD A. DWYER ( 714 ) 646-9059
aooxess: g34 EVERGREEN PL
COSTA MESA CA 92627
UCENSE� CONTPACTOfl DECUINATION: I here�y affirm thal I am Iicense0 untler pmvisions o� ChaD�e� 9(�ommencing with Seciion
7000� ol �iv�sion 3 0l Ihe Business and Professions Code, antl my license is in tull �orce antl eflecl.
CITY LIC.: � STATE LIC: CL4SS:
Date: Signa�ure:
WOBKEflS' COMPENSATION OFCLABATION: I hereby afiirm �hal I have a cetlilicaie oi consenl �o sel4insure or a ce�ifica�e ot Workers'
Compensalion Insurance. or a ceni�ietl copy ��ereot �Section 3800. Lab. C).
POLICY NO.: E%P. OATE:
COMPFNY:
❑ Cenifie0 copy is here�y fumishe0. ❑ Certdietl copy is liletl wilh �he ciry Building Division.
�a�e'. APDlicant:
c%EMPTIONFHOMWOflKEBS'COMPENSATIONOECIANRTION: � ec�ianneea tbecamDletediilhe e u�iso hunGrea(511q�arless).
I certity ��at �n �he pedormance oi Ihe woB br which ihis rmi� is issuetl. I II no� em0 ny son in any m nner so as to 6ecome
su�lect lo I�Ae/ly, ,o,rk�ers' C �pensation Laws al Calilomia.
Date: J / L`7,_��3__ Signature: �
NOTILC�II, afier making IA¢ aeclara�ion. you shoulA be ome subjec� to ��e Warkers' Compensa�ion pmvision t �he Labor
Cotle. you mus� larthwith comply with suc� pmvisions or �his permit 5hail he deeme0 revoked.
CONSTBULTION LENUING AGENCY: I hereby a�tirm thal Ihere is a cons�mction IenAing agency for t�e periormance ol �he work �or
which Ihis permii is issued (Sectian 3097. Ci¢ q.
LENUEfl:
AOUPE55:
OWNEP BOILOEH UECNNATION: I hereby a��irm Ihal I am exempt Imm Ne ContraclorY Slate License Law �or Ihe tollowing reason
(Seclion 7031.5 Business ana Pmfessional Cotle'. Any city of county which requires a permi� m conslmci, alier, improve, Oemolis�, or
repair any sbuclure, prior Io i�s issuance. also requires �he apPlicant for such permi� lo file a 5igne0 statement ��a� helshe is licensed
pursuam to Ihe provisians af Ihe Con�rac�o5' Siale License Law (Chapler 9(commencing with Seclion 7000) of Division 3 of the Business
and Pmlessions Code� or Ihat he/she is exempt ��erelmm antl ihe basis lor �he allegetl exemption. Nny violalion o� Seclion 7031.5 by
any applican� for a permi� sub�ec�s Ihe applicant to a civil penalry ol no� more I�an �ive huntlretl tlollars ($500).
I. as owner al ihe pmpeny or my employees wilh wages as tAeir sole compensa�ion, will tlo Ihe work, an0 �he
❑ slmcture is not inlendetl oroiferetl for sale (Seclion 7044, Business ana Pmfessional Code: The Con(ractors' Sia�e License Law
tloes not apply to an owner o� a pmperty who builds or improves ihereon, antl who does suc� woB himsell/�ersel� or Ihmug�
his or her own employees, pmvidetl Ihai such impmvemen�s are not in�entled or otferetl �or sale. I�, �owever the building or
impmvement is sol� wilhin one year ol comple�ion, Ihe owner will have Ihe �uraen of pmving he/she did not build or impmve
br �he purpase of sale�.
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 06081]
PERMIT NO; M 060811 PLAN CHECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE; 5—N PERMIT TYPE; MEC PURPOSE: OTH
SOB DESCRIPTION ; INSTALL FACTORY FIREPLACE SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /
COMMENTS; THE "TEMCO" FACTORY FIREPLACE ICBO#3195 / RE: B60810.
�r*��r�t*�r�r*�t�r***��t�**�****�t*�r*******�t**�t***� **�t�t�t��xx �t�r*�r�x ***�r*�******x **�t*�r*�t**
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT': FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT ZN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 42252108 ZNE; REF NO:
PLANNING Nf51'ES>
i
***�*xx �*x***��rx****�r�r�r�rx*�r�r�r,r�r�r�r�r***�r�r�r*******��**�r**�r�r*****�****�r****x***�t*�t�r
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
BUILDING APPROVED BY ;
APPLICATION ISSUED BY:
�E M iE iE ik iF ik iE if !E ik if if iE iF iE if 1E k iE iF if
1E ik if iE k iF ik k if if ik iF iF iE it iE iF if i! if iE if �f iE �E iE if iF if iE if 3Fif iE �FiF iE iE i! k iF iF iklE iE iE if
LEGALIZATION;N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 6�SY
PLAN
ISSUE FEE 15,00
DATE;
DATE;
�iFiE 3E iE if 3F ik!! 1! if iF��iF�E 3F
iE if it jF 1E 1E �E i! 3! iE if iE iF iF iF iE iE iF ik ik iFiE if iP lf ik ik
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECR TOTAL PAID DUE
TOTALS----> 6,50 15.00 0,00 21,50 21.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 21,50 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner o� the D�operty, am exclusively conVac�ing with licensed canVac�ar5 ia constmcl the pmlecl (Sec�ion 7044, 6usiness 2 1, 50
❑ ana Pmlessions Code: The Conirac�ors' S�a�e License Law does not apply Io an owner of D�opehy who builtls or improves lhereon
antlwhocomracisforsuc�projeciswithacamraclor(s)IicensepursuanlmtheCaniracmrs'StateLicenseLaw).lamaware {f.��..�*.{{.{�..7E.�*.7E.7�{f.�*.*.{p.7f*.{(.�..x.{E.ki(.%iEiE{t*{E.lE.lk*{p.K.{�.{�.{�.{(.{f*.*.j{.�{.{E{f{p{�.*{p.�*.�{.{E.x.{�.{E{F*{�.�(.�p.x..lE.1Eil..7Ei(.iE*{�.*�.{E.K.�.�..�.
mat pmof of iheir Worker's Compensation insurance shoultl �e provieetl . I N D I V I D U A L F E E B R E A K D O W N
� I am exemp� under Section:BP -� O 4 4 B. 8 P. C.
mrmisreason p�JL WORK BY OWNER + TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date: ���zfi.�9.3 Ownec
i Uo hereby cenify �hat I am aware of and unders�antl ihe requiremems ol Califomia Health anA Sa1ery Code Secnons 25505, 33, an0 MEC 1 FACTORY F I REPLACE 6. S � f, S �
25534 antl ��at I or any WWre builtling occupanl willlwill noi (circle one) neetl �o comply wiN said Slaie codes ana lhe requirements for a �ND �F FEES
permi� �oi cons�mclion ar motli�ication �mm ihe Nir �ualily Management �is�ricl. flesitlential cons�mciion aOPlica�ions are exempi Irom �� ; R,
Ihese pmvi5ions. :'p �
"i
Wte: ApplicanP.
I hereby cetlify �hat I have reatl Nis apphca�ion and s�ate 1� e above in�orm on is correcL I agr o comp ilh all ciry and counry
ortlmancesandstatelaws�elalingto�viltlingconslmc�ion herebyaulhorize resen�ativesofl�i ilytoen�erup �heabove�menlionetl
pmpetly tor inspeclion purposes.
i
. �a�e' � 3 Siqnamre:
Driver's License or Sociai Seari�y a: �
Canary—Appli<anL Pink—Revenue: Goltlenrod—Assessor
�
EXPIRED
t pl e �nspectwni
�a Ll�i���Y�`�
:.� 'n.�' . _ .t- . . .. . .
I:' ,_ 'J_�. . -� . .
- � 4
CONSTRUCTION AND PLANNING . . POOL & SPA , '
APPROVAIS PeEinit # Date Inspecior qPPROVALS Permit # .Date tnspector
1. Temporary Electrical Service or Pole - - 52. Poo� & Equipment location � -
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � �
3. Electrical Conduit Uti�ity•Undrgrnd. 54. Forms � ��� '�
4'. Electrical Condtlit-Undrgrnd. 55. Etectrical 8onding - �
: 5. Steel Reinforcemenc 56. Rough Plumbing & Pressure TQst'
{ 6. Electrical UFER' Gmd. 57. APPROVAL TO COVER�GUNITE �__
� 7. Footings „ 56. Electrical ConduibUndrgmd. ��
�'$, Foundation • 59. Gas Pipe, O Undrgrnd., Test •' �
•- �
- 9. Water Pipe�Undrgmd. 60. Backwash Lines, P-Trap, O Undrgmd. � , �
10. Structural Floor Sysiem , � 61. APPROVAL TO DECK , '
1
11. Properry Sewer Lir2'& House Connection 62. Back4vash & Recep.or-Finai � �
� �
72. Sewer Cap . 63. Heater & Ven[-Final
13. Root Drains _ - � 64. Plumbing SYstem - Finai � '
14. Rough Plumbing 65. Electrical-Final ' �
75. Rough Electricat-Conduit � 66. Solar System-Pinai ' � � '
16. Rough Electric Wiring 67. Fencin� & Access ApP��val � .�
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING ': �' .
18. Rough Electrical-T Bar Ceiling 69. POOL(SPA SYSTEMS FINAL ' •
19. Rough Heating & Air Conditioning 1 ,� FIRE DEPT. REQUIREMENT '' .
20: ;Aou9h Factory Firep�ace � � r � `c - � � � `APPROVAY.S' Perc`l5it #�` �' ' :
21. Ducts,inStrncture� � •• � � � � - * -70. UndergFopnc�Hyt7ro •
22. Ducts, Vontilating . � "'� _ '- �71. Produc4P,ipin9 � Gas �7_Oil
23. Gas Pipe-Rough &'fest � +- , •. ;❑ _ ,72. UndergroLnd Flusii • "
24: �floof Framing '. � � �. "' . ' ' -'73.' Undergrnii. StoragaTank � Gas ❑ Oii '
25. Roof Sheathing , �i • � � -. � � �74.�Overhead HYdro'• . �
�
26. T�Bar Ceiling (Structural} &�Monocoat '' _ � '��, ;� 75., Dry Chemicai . �� ' - �i � �
27. Frame and Flashing� l,; z, . - .. 16. D�y Standpipe .- • .
28. t,afhing & Siding� .. � . `•� ..�•; , 77' FIXED SYSTEIut �.INAL . r �' ' ,
Y29. insulation ' ' � 76? FIRE PREV. FINRL ' • ' , j,`y
30. Drywall Nailing . ' � �j � ' _ HEALTH�DEPT: REQUIREMENT ' �
31. Plaster Bro�vn Coat� � � ; j. r79��FINAL IptSP_ECTION �. � '
t�� - �_ �
`,32' Electricaf?o�er�MAie.-Final '' �'J ��A i '80. FOOD CERTIFICATE ISSUED,. ' �
•.33. �Final Electric. � , . ' '� �, ; ��Notes: . � -
�34. Final Heating�& ftir'Conditionirag• • � � I- , - r^ - . - -
�_. 1- - _
35. Final Gas Pipe�Test � . � � � � ' ,.� _ . � �"
i
36. HoodorCanopy�' - - {'�' ' �'��
j • c.-
37. Finat Factory Fireplace � ' . ,i �. � .,
{': -
38. Final Plumbing '. i ' �-" - •- .. .. . " -
" S ti
39. Water Service-Fina4. - . . ' I �: .: ` " � � `
40. Gas Service�Final t� , � I �
41. Solar pomes[icFfna� ' _ _ ' I ==, ' _
42. Backflpw Preventer � t I " ' - �
� .
43. Backflow Irrigation " ' ' _, �. ' , • .
44. �andscape Irripatton System � � . ' " . ._ � ' - � -
r
45. Sound Atteni�ation ' . � . � _ _ . � ,
�46. Handicap fiegulations � _ - _ _
i
47. FINAL STRf1CTURE & BUILDING �;,; , - '
48: FINAL PLANNING � i' . i �
' 49. Electric Release to�Edison � (� . � �
50. Gas Release to Southern California Gas Cn -�,I � �.
51. CER.TIFICATE OF OCCUPANCY ' - • - !
No. Date
ADDRESS
11-2
BUILDING PERMIT NO.
VALUE 3 1.13 .00
& Ent.Hal
INSPECTIONS a„� DATE � GROUP 1 TYPE V ZONE N•.L b0 ��
Underground Soil/a,(./,OU.G. Water�_L!/ /-��n PERMITS ISSUED
__ . . _ � I SUBCONTRACTOR I
OCCUPANCY
Form 210—SM-11-59 S-B P . 13310
,
'"�, .. ' �ticA . .
C�STA �RESA BUILDINGSAPETY DEPARTMENT
P. O. BOX 817 C08TA MEBA. CALIPORNIA
For Applieani fo Fiil In Compleiely
CASTA MESA
■ 6TATE
Y 86TBACK LINE FftON
BUILDING �'J�� ��
s�ze. .
EXTERIOR WALL
GOVERING
U9Hp�JBUj6DJNG AND
�
��
TEL.
NO.
INO. OF GLDGe.
OF WORK
-EE RECEIVED
�NOV 231960
fINANCE DEPT.
CIiY OF COSTA MESA
APPLICATION FOR PERMIT
euaui��
For Office Use Only
FECEIPT NO, %ERMIT %O.
3 �
e I ��'�'Plerv/oo0 I ��A.�%'6�u�o� d
TA MESA. CALIFORNIA
TYPE GROUP
�
_�� ��.�a _nsTc�l—� 3{J
ZONE y YiO.OF c� lISE OF NEW (/.��/
� i PLAN9 L BUILDING L} i
� ////// O � -va�
LEGAL � ^ . S� / rR �
OE9CRIPTION ��C/
A. P. NO. � .� �— / / /�' �% �
YARDS EVES
APPROVED ALLOWED
(CENTER LINE BTJ .� f ,
FRONT �� FT/. i��
R.SIDE �LZ/�� ICYI `--�0`�
)
L. SIDE / 7FT.
REAR (,(�' �.�-e��
APPROVED �,I ^ 7. �`/� nerw I� '
RY
v s •. � ^ , ,'' � • - 'V
^ � �� �� A a�v
1 H6P[C( AGKNOWL�OH THAT 1 XAVB.RPaD TXIB MpLIWTION TqQ AMOUNT eHOWN UNDEft VAWAT�ON IB FOH'THE
AND•8TAT6 THAT TH6 I100V6 18 CORRCCT AND A6REC TO COM- p�JppOBE OF, EBTABLIBXING A PEPMIT FE¢ ONLY.
PLY WITN ALL�C4 ORDINAN�88 AND 8TAT6 LAWB R60ULATING
BURDINO CON CTION. � VALUATION 9
SIGNATURE O `� PERMIT FEE $ // �
! ' n
PERMITTE ` S�/� � av PLAN CHECK $ � ¢
AUTHORIZED AGENT �
TOTAL FEE � ^ LL
OWNER �'hp Frank C.
� DATE.. 6'%—S� • ... .
JOBADDRESS 934 Evergreen Pl. BUILDINGPERMITNO. ��'1�t�/
GENERAL CONTRACTOR Owner-Builder VALUE $ �.�OOO.00
LOT 2S6 BLOCK TRACT 1712 . Patio
IWSPECTIONS
Foundation Forms and Grade
Plumbing, Rough to Slab
Plumbing, Rough Complete
� Heating, Rough
Heating, Final
Sewer
Septic Tank or Cesspool
Lathing
Plastering
Plumbing, Final, Fixtures
Plumbing, Final Gas Test
Wiring, Final
Occupancy
P'orm 210 C-H 1M 12-68
ZONE FIRE DISTRICT '`J S �
I PERMITS ISSUED
DATE SUBCONTRACTOR
DATE I. NUMBER
sta Mesa Building Depar en
, 111 EAST STREET' ,
COSTA MES. LIFORNIA
FOR APPLICANT TO FILL IN
��' . cli�ls'�P��N_��
Costa 1Vlesa, California
Owner
or
Lot
Size of Lot
Use ot
3�'
No.
City Lic.
N o.
APPLICATION FOR P�RMIT
33� .--- -- ' 1 L.D_I_N.G ...__ -'�:
I FOR .rF'�'ICE USE ONLY - ' !.
_ � • Receipt No. PermitiNo. �
; '
, : �,f-D C `� �' /, �- I
r , :.
Received by Date Rec'd. Date IsSued �
_ ; ; ' 6_ i -: s-� �
e��ia��9 ,
Add�ess � � (,
— i Costa Mesa, California ! `
Nea�est � �
Cross St. I . . , 1
No. of Bidgs. 1
Now on Lot
No.of / I No.of �
Families Rooms
Date �
CORRECTIONS ; �'
' _.
/ � ,
' {i
w !�1 � �
:c-.,...__._.. ._. . Q
, �, A
�
__' _'_" ' ..' ___'_
Z
,-,r�d D
r
Repair • � � �Moving ' . ' � . • I Demolish I , �
+� Building No. of �
Size ���SQ�j"Rooms Stories . . ,
Exterlor,Wall' ' ' Roof AppROVALS
� Covering `��!UCC:b I Covering A'.iB� S+(i/N�i,
.�Useof.New. n^ • �- � FoundationLocation Inspectar Date
Building /-S�V Q - � � � s. �{Q ' pprms, Materials� �
:.Q ��LI �6 �/ �/ � Under-Pinning . .
, , , . �.. . . . . - _ . . . Frame: Fire Stops, ,
Bracing, Bolts ' ' �
. . ._ �� . . <t , ,
I-herebY acknowledge that I have read this Application. Lath. Ini.. � � -�
� and state that the above is correct and agree'to comply � Lath. Ext. � ' � �
�vith all City Ordinances and 5tate Laws regulating '
building construction. , ,
Signature of ^� _ , Plaster, Int.
Permittee ��Q3 � �.�LIW�
Plaster, Ext.
. Authorized Agt. - Masonry ReinTorced
Valuation Permit Fee $ r o . .
Plan Check $ v� Bond Beam
$�� Total � DO .p Q C-rG / � % -i
Fee a FINAL
i,��.� zna r,- it� iz-sa .1
_. .<` .� . . ..... =. •'' _ _" . }`��fF ,� .rrj • ��✓ � . 1. .. _. ,�
._�. i. � . ._ .. . . . . .
..� . ' /�" G � . � .....�i.�.. )... __ _� _
I a O ' a ' __' " __ ��"� _"""" ..= - __. �.)' _.. _'_ I, ••
. . .. `v� 1\.�� . • 1 r . . �+ .._ _ - � _ ': I":v
��
. .. ' O�% . '�f ' _. ..� .�..__.. .��lv� _ . � \. . .. _` ,�'�a• � .
. ' I! �%� �_ �' , r,� . ' ... • '
� \
. _ � � . . ' .. ._ —. �. _ � '
1" �Q � � .. _ _ . . . �'
, . � ._ � � t � �1 'a_ �
' ' . - ,-i i . ' � 'J _ _ . .. t` t?' ..�. .
�" y '
�� fN'"'ti "J �. J.' � . j '
,.y..°r_':,".�- :
. ,., .w,: . , , ,;�
:
. -- — , ,
Street . •� r;� �,� . � � . .�,,; . - • •��
;�7r .. . . ' . .
..' + ' � �� ' �� . . ' ' f'
, �-EI:UT PLAN - � � � .. . _ , . .
� �.. r�. :� rti
; Show loeation arid ldistances;from " � � �
' � 'jl �i�'�� , -'`. - . ' . i
property line and between 6uildings: / j\� ' '
�o yoi�1 c8rry WorlQuan�s Compensation
�. ..;, �
��sa�.-c4-�e_o-���_�. _ I��isrance4 Yes � No � ,
�"�'�`- `a"Q�' ����. I�id sware of Pr.ovision 3700 of the State
�,i�oa.o�o�,ta�+xa�4s.z., A��-a, �'�' Labor Code which requires every employer
` � � $6 b8 insured against liability Yoz'.
A�4-e- `�^�`��.�9'�^�.-a-e-�.�:.,�on,:s•J.
� � _ _ , ko3�km�n's compensation.
j��' � .. �i�ned•l� liJ '\�. �IAA�AK )
. n.o��� ...�cfl.. iu..s-4., .9.+.�. �..�,
O't� �+U �..,.. d�o-kti � <� �
I:vus. U � ... . ' .
,
, .. � �- , .
� . - � . � ,
: .� ._ ' .i, , .
,
-- --- - - -- - - _ ___ __. ._..
- �.
HERRiti1ANN, Pauline
JOB ADDRESS
GENERAL CONTRACTOR Oti
AP No. 11S-U.91-O� LOT
INSPECTIONS
r
TRACT
� Signature
SEP � 1 t ti96�
BUILDING PERMIT NO.
VALUE $ 3,732�00
FIRE ZONE DESCRIPTION OF WORK Add
DA'I'li GROUPI & J TYPE TJ ZONE g_
SUBCONTRACTOR
,
, : . ;'•:'�
, ; , ! �t�.
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 977 COBTA MF$A, CALIFORNIA
- For Applieanf fo Fill In Complefely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
TE4.
WTY S � NO. .
ARCHITECT T'� TEL. -�'
OR ENGINEER NO.
ADDRESS
Ciil' —'
STATE �• TEL. �^
LIC. NO. NO.
OF LOT�/ OX i7 X I� X�� 6 I�o, oP, BLDa
/ Si NOW ON LOT
USE OF ..�� 1
EXI9TING BLDG. . C-� : l� STpf2 .�/,� tr
SBTBACK LINE FROM
CHM¢R OF BTR¢ET �2 REAR YARD �
SIDE YARD I LEFT I RIGHi �O
DESCRIPTION OF WORK
GWALL J�✓e�17I COVERIf
BUILDING ANC� H'ORK TO BE
I-HEREBT AGKNOWLEDGE TMAT � HAVE REA� THI6 APPLIWTION
AND 6'lAiE TXAT THE ABOVE 18 CORREGT ANO AGREE TO COM-
PLY WITM ALL CITY ORD�NANCEB AND BiATH LAW9 REGULATIN6
BUILDIN6 CON�1CTION� // -
AIC.NATIIRR'AF� 11 � f^/ /✓' r..
AUTHORIZED AGEN7
�
FEE RECEIVED
;� � MAR � a 1962-
FINANCE DEPT.
CITY Of COSTA MESA'
APPLICATION FOR PERMIT
BUILDIMG
For Office Use Only
RECEIPT NO. • ➢QRfdlYaJiD.
BY
MESA.
FIRE , hi � . l / �
ZONE V TYPE GROUP t•�'�
BYP D ATE � `Q
Z I G �
ZONEn NO.OF U6E OF NEW
n �r PLANB Z HUIiD�NG ' /�/�
LEOAL I ..� (�iT � S� � 2S_C !'/r /? .
DEBCRIPTION
A. P. NO. / �S T� / / � — � (7
YARDS EVES
APPROVEO ALLOWEO
fClNTlN LINC BT/ )y[ r
FR[fYT �-Y(/R.L T � �/l�f� IN
ICO � FT. IN.
�U � FT. IN.
' a . FT. '_ IN.
�� i < � I]ATE .3�L7�<t
3/I 6 '" 5�
TXE AMOUNT BHOWN IINDER VALU ION IS
PUIiP08E OF EBTNBLIBXING A PEpMIT FI
ALUATION
�i 73ai �� PERMIT FEE $
�� �
P�AN CHECK � $ '.
/ �
_ TOTAL FEE y eZ
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JWNER }(EFZRMANN� PAULINE � DATE 2-11t-�6 _ -
n J
��OBA�DRESS 93� Evergreen .St� - ���� ��,q�� BUILDING PERMIT NO. 2352
n
3ENERALCONTRACTOR Owner-builder MAY 1 3 1957 VAIUE a 936,0�� �
.or 257 s�ocK TRACT 1%12 Garage patio att, to dwelling
�ROUP J TYPE V ZONE RZ FIREDISTRICT 2378
PERMITSISSUED
NSPECTIONS DATE SUBCONTRACTOR DATE � NUMBER �
�aoting Trench r' �C�G �
�oundation Forms and Grade to Grasrage -
iough Framing C�r� � �'.Z
' 'lumbing� Rough to 91ab ���
�lumbing, Raugh Compiete i�d �J �
i emporary Pole
Niring, Rough
ieatinq, Rough /�� b
ieating, Final
�ewer, House Sewer, St.
ieptic 7ank or Cesspool
_athing,ln Out%�� / �}
�lastering
�lumbing, Final, Fixtures Comptete
>lum6ing, Fin•al GasTest
/ Niring, Final
f JccupancY .. .2�i �i_
�FOPM2 3M�10�95
1��/
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.�
�LJJfs,
2352
:�a Mesa Builnu.D�-__� ,kznt APPLICATION FUR PER1VIdT
� 111 EAST.2 th STREET�+-� .. ���� I`D i� � G '
1 •-•�� COSTA MES LIFORNIA�
. -- -V FOR �`ICE iISE ONLY ' . ;
FOR'APP ANT TO FILL IN Receipt No. Permit No. '''
euudin9.., { - - -- -- �4I , , : .�
y � �.��3sa�
Address � a� ' p5 �
� Costa Mesa, ri � 01711fl� Received by DaM Rec'd. �Uate Issued ,
��/I �
Nearest ��%� .' a _ / ,_"'.�d>� % ' S6 .
Cross St� Building . E �
,� - �Address . � � ,
Ma ler � Costa Mesa, �'i&11fOP111& � � ,-
Addre � � Nearest . j ' f/ � ��
. Te�l.n Cross St. 1 _ '� � : �; . i
City n� No:�• Zone J I plans �� I T;pe/ii ` i Group '�
Architector � Lio. � 7
Englneer No. Approved� � ' � I. ��+!�+�-+
� � bY � ' f i i ..^:,`. � Datef .,. ..:
Address � � CORRECTI011TS
• City Lfc.
Contrector No. � _ ) i
Addrew ' - � +
Descrption I No. � I Block I Tract E ! �
. - - � ..'L �9
(Attach M6tes and Bounda) ' � 't =; !�
/ .�'/%O k .�!(S No, of Bldga +
Size of L6t � Now on Lot � I �Z ;�, ., ! �
Useof • I No.W I No.M — - - . T� `•- ' �
Existing BI Famiiles Roo _
Setback Line from Rear Yard � �• -� . r� • _: � V� �
CenteroT 8Rreet .Side Yard . / � ' "� ' -" - ' - - y
DESC ON OF WORS ---- �
New I� I Alteretion I I Addition I � � -�-i; b�,- � -• �:��"
Repair I I Moving I I DemoNsh I -� �' �-� �``� '
- Building ' ' ' No. of � •.
Size Rooms Stories
Exterior Wal}' I Roof �`/ •
Covering / Covering: d�., /AI1P�`7�s
Build�ng�W�� �CLIi(.jJ � Foundation Location Inspectoe,.� Date
Forms, Materials, �+
Under-Pinning "
Frame: Fire Stops, r '
Bracing, Bolts i'�
v.
2
I.hereby aclrnowledge that I have read this Appiication Lath. Int. ___o
and state that the above is rnrrect and agree to comply '" �
Lath. Ext. "�G'
with all City Ordinances and State Laws regulaUng s--
building�constr" li ction. �"
� �/ Plaster, Int.
Signature of 7i�.. /1_ ' -, L,_��L "'
Permittee I.LU{; elwnb 7i� � pH
, Plaster. Ext
Authorized Agt. _� � -
Mawnry Reinforced '
Valuation d PermitFee $ �, o • ;� �
9� � Glan Check $ r.� Bond Beam ;.
,y•
$ Feea� s 6- a FINAL '�
FORM 204 G-H =M �-5a , i _ ,
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; -- PLOTPLAN . - __�.. � . . --- �`;-.
. Show �loc.atlon and distanxs from� _ � . � ^'•'�'�:. . _ "'�:F„"',- - _ - �`� '' ��
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OWNER HERRMAAIN
JOB ADDR.ESS 93
GENERALCONTRAi
INSPECTIONS '
Underground Soil:;�
Underground Gas
Overhead Water and
OCCUPANCY
• ,�ly
AUG 1 0 t961
ni� ; .--�T,Q,oc�� �
:tACT FIRE ZONE D
DATE I GROUP I
---I SUBCONTRACTOR
DATE
VALUE
PERMITS ISSUED
_ G 2`. I�! lo � 4" D' �
Form 210—SM-11-59 S-e P � � U , 1'Z8�1
ORANGE COUNTY BUILDING DEPARTMEMf' i � APPLICAYION fOR PERMIT ~�
� 636 Na oadway �
• , SANTA AN. .LIFORNIA ' ' • ' � . �� �'�— - -
FOR APPLICANT TO FILL IN —FOR OFFICE USE ONLY •
RECEIPT NO. PERMIT NO.
BUILDING a„Q I �. ���/ I� �/' j'
AooReSs . 9$4 EVp]+d�_� pn P�ACP. ,. � J �i
SCHOOL �IST. {. REC IV D,BY DATE REC'D. DATE ISSI+ED
ORTOWN COSya MeSA
NEAREST � � �\�'j ,�� C�
�Ross ST. Monrovia � J J J
OWNER BUILDING
�� Chinoo HomPs 'Inn� ADORE55 � %�
ADDRE55 9363 Wllahire BZVd� SCHOOI DIST.
OR TOWN
AP va rl y Ni 1 1 a TE`.CR 54361
CITY NO. NEAREST INA. �����, '
CRO55 57.. ///ZlyJ
ARCHITECT R ` IC. ZONE NO.OF TYPE `GROUP
ENGINEER �Aj.il B! �•yQReY't`AC�i �� ,y� � i I PLANS I ��' ^j— 1
ADDRE55
LIC.
NO.
aooREss
�ESGFIPTION I rvo. �',��-j� BLOGK I TRACT j-
fATTACH METES & BOUND51
NO. OF BLOGS.
SIZE OF LOT 4(� X l��r"1 NOW ON LOT O
USE OF NO. OF NO. OF
EXISTING BLDG. Fqrv:i�i[s ROOMS
CENTER OF'STREETM� 5O P4. SEDE YARDj ,���
DESCRIpTION OF WORK
NEW ( X IA4TERATION I � ADOITION
REPAIR I I MOVING I I DEMOLISH I
BUILOIN NO. OF ,1
size 034 an P�ooms �j STORIE y,
EXTERIOR WALL ROOF O1TIA O
COVERING Stunrn I COVERING Qhjpp�
USE OF NEW
BUILDING Qoa{r7e.�ne_A++ /�..r�rn�+i'
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FOIFMS,
APPLICATION AND STqTE THAT THE ABOVE IS CORRECT UNDER�P
ANO AGREE TO COMP4Y WITH ALL COUNTV ORDINANCES FRAME: FIRE
BRACING
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. _
LATH. INT.
SIGNATURE OF ^ i LATH. EXT.
PERMITTE V
✓' ' PLASTER, INl
AUTMORIZED AG � pLASTER. EXl
PERMIT F MASO/JRY RE
VALUATION $�830�00 P�pH Gxec�$
BOND BEAM
FEEA` /� FINAL
9-30-09
CORRECTIONS
APPROVALS
ION I I� TOR
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STREET-
PLOT PLAN
Show location and distances from
property lineand betweenbuildings.
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