HomeMy WebLinkAbout2807 EUROPA DR - Building Permits(714) 754-5273 • Fau (774) 754-4056 • www.ci.costa-mesa.��LDING PERMIT 77'FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2807 EUROPADR
Suile:
Viciniry: ROOF
Primary Occ: R3
Parcel Number: 13940407
Applicant: MILLER, GLENN
Address: 2507 EUROPA DR
COSTA MESA, CA .� � . '
Owner. MILIER, GLENN
Address , 2$07 EUROPA DR � "
.' COSTA MESA, CA � `"� �
Contracror: OWNER-BU ILDER
Address:
Zip:
Arch :
Address:
Type of Construction: V-N
Zoning: R1
Phone:
Zip: 926263525
Phone:
Zip: 92626-3525
Phone:
.License: 000000
Eng:
.Address:
Status: ISSUED
Applied: OS/31/2005
Issued: 05/31/2005
ISSUED BY:
� � . - Phone: . Phone:
2ip: � � License: License:
" SCOPE OF PERMIT
�TEAR OFF EXISTING MED SHAKE ROOF AND SHEATHING: REROOF WITH�50 YEAR DEMENSIONAL ASPHALT SHINGLES CLASS A ON
ATTACHED HOUSE qND GARAGE. " �
Plan Check: $0.00
Permit: $8325
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83J5
SETBACKS
MAIN STRUCTURE Front , 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
> FEESUMMARY." ,
, � , ' , . . Calc Valuation:
' " Claim Valuation:
-- �
� PLANNING & ZONING : � �
�� �
Rear 0- 0 Left 0- 0- Right . 0- 0
�.Rear 0- 0 � Lefl . 0- 0:. ',` Right 0- 0
Reauired: 0 - � � Proposed: ' 0 � � �
sz,soo.00
$2,500.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 72-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days. �
� INSPECTIONS: In order for the work euthorized under this pertnit to be considered' legal, such work must comply with all applicable codes, and all
reqWrad Inspactions end flnel approval must be oMained. Failure to obtain inspections��and final approva6will resultin the expiralion of this pertnit.
FOR INSPECTIONS CAL�: (714] 754-5626
.+o+n �ew�
WORKERS'COMPENSAnON DECLARAnON: �'
I hereby aHirm under penalry oi perjury one of the following tleclarations: ; �i�.. .' �� ,
❑ I heve entl wlll melntaln a cenifiwte of consent to setl-Insure lor workers' compensatlon, as provitletl for 6y section 3700 al the Lebor Cotle, tor t�e pertortnance ot the
work br whic� Ihis permii is issuetl. ' • �:�
❑ I heve and will meintain workers' compensation insurance, es required by section 3700 of the Lebor Cotle, for t�e pedormance ol the work for wNch this parmit is issuetl.
My workers' compensation Insurance carner and policy number ere:
Carner:
not
et one huntlred tlollers (Sf00) ar less.)
Polity Number:
�.f.��l;�rtity that in the peAormence o ihe work for whic� this�permit is issued, I shell not employ any person in any manner so es to become subjecl to Iha workere'
�compensetion la f Celifomia, nd agree that if I shoultl become suD�ect to the workers' cwnpensetion pmvislons ot Sectlon 3700 0l Ihe Lebor Cotle, I shall forthwith
comply wi�h IheS p visi `
Applicenl Sipnetur ' � �� Dat .a: ^+-t� �� � I d �
�. ����
WAR : FAILURE TO SECURE WORKERS' OJMPENSATION COVEiiAGE IS UNL4WFUL AND SHALL SUBIECT AN EMPLOVER TO CRIIAINAL PENALilES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE (5100.0OO�.IN ADOIiIIXJ TO THE COST OF WMPENSATION, UAAMGES AS PHOVIDED WR IN SECiIIXJ 3i060F iHE LABOR �DE, IMEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby efllrtn ihat I am licensed under provisions oi Chapter 9(commencing wilh Section 7000) of DiNsion 3 ot the Business and Prolessions Code, end my license is in full
torce antl eHect. LJc. x Glass x
Contrectors SlgneNre: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aflirm that there is e consiruction lending egency for ihe pedormence of Ihe work for which Ihis permit is issued. (Sec. 3097, Civil Cada).
Lenders Name: Lentler'S AtlUress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aNlrm ihet under penelty of perjury Ihet I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professlons
Cotle: Any clry or couny whic� requires e�permit to consiruc�, elter, improve, demolish, ar repair any strucWre, prior to its issuance, elso requlres the epplicant for such permit
to tile a signed statement thet he or she Is licensetl pursuent to the provisions of ihe Contrectors License Lew (Chapter 9(commencing with Sedlon 7000) of Division 3 of the
Business and Professions Gode) or Ihat he or she is exempt tharelrom end Iha besis tor the elleged e:emption. Any violation oi Sectlon 7037.5 by any epPlicant far a pertnit
sublects ihe epplicent to e clvil penelry of nof more than flve hundred dollers ($500).):
❑ I, es owne� ot t�e D�oOerty, or my employees with wages as �helr sole compensation, WILL DO THE WORK, and the slructure is not intended or ottered for sale (Sec.
7044, Business antl Professions Cotle: The Contractors License Law does not epply to an owner of properry who builtls or Improves thereon, antl who tloes such work
�Imsell or herselt or t�rough his or her own employees, D�ovided that such impmvemenis ere nat intendetl or oflereC lor sele. Il, however, the Duiltling or improvement is
Itl within one yeer ot completion, the owner-builtler will �ave the Gurden of proving that he or she did not builtl or improve for purpase ot seleJ.
- tri , es owner af Ihe properry, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consWa the prqecl (Sec. 7044, eusiness end Professions
Code: The cantractors LIpense Law Coes not eppty to an owner oi propeny who builtls or Impmves thereon, anA who contrac�s tor such project with a contractor(5)
license pqrsuant ta the Cpmreciors License Lews.).
❑ lem
drivefs license. ❑ Yas ❑ No
Business entl Professions Code tor �his reason:
Venfication af Ownership by (type of tlocumen6 i.e. � property taa blll ar tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceriify that no excavation five (5) or more faet in depth into which a person is required to descend, will be mede In connection with work euthorized by this
pertnit, and that no building siructure, scaflolding, felsework, or demolition or dismantling Ihereof, will be more �han �hirry-six (36) faet high. (Chap. 3.2, Grp 2, A� 2, Sec.
341, Title 8, Celifornia ACmini5lretive Cotle).
❑ As owner-bullder, I will not employ anyone �o tlo work whic� woultl require e permit irom the Division of Industnel Sefety, as noted ebove, unless such person hes a
permit to do such wark fmm the division.
SignaWre: Date:
Division of Intlus�rial Setery Pertnit Number:
CERTFICA7E OF COMPLIAN D AUTHOR ON OF ENTTiV: I certity untler penalty ol pery'ury that I have read this application entl stata t0et ihe infortnation given is
correct I agree to comply wit all ate laws and c ordinances releting to building wnsWction, and authorize reprasentatives oi ihe Ciry ol Costa Mesa ro enter upon Ihe
ebove-tlescribed property for i spec �on pi po es. gree not tQoccupy or allow occupancy ol any huilding authonzed by lhis permi� until linel inspection.
COOE �. INSVECTION TYPE ' ' ' � �
1616 Pixed System Final Fire�Prevention
1266 Pool 5Da Final
200 Finel Re�Rooi -
201 Flnel BIocWReteining Wall
202
203
204
Final Factory Fire Place
Final Sign
Final Demolition
PAIF. ' Ii�6L$
CODE� INSPECTIONTYPE
206 Finel Mec�anical '
208
270
212
220
Finel Plumbing
Finel Electrical
Final Flre Prevention
Final Planning Approval
222 Final Site
250 Final Building/Occupancy
Pdg Iti�LS
�oeess: zg07 EUROPA DR
rsname: WITHECK FRANK W
nooness: zg07 EU{20PA DR
COSTA MESA,CA
557-9727
PHCHIENCMEEfl:
aooxess:
�_: _1=� �N�,:
92626
NEG.NO.:
uxit:
PENMITTEE: FRANK W WITBECK ( 714 ) 557-9727
nooness: zg07 EUROPA DRIVE
COSTA MESA CA 92626
UCENSEO CONTBACTOH OECNNATION: I hereGy aifirm ihai I am licensed un0er pmvisions o� Chapier 9 �commencing wii� S¢clion �
7000� o� Divlsion 3 ol ��e Business and Pwlessions Code, an0 my license is in lull force and efle[I.
CITY LIC.: STATE LIC.: CLASS:
Oate: Signalure:
WOBREPS' C�MPENSPTION DECtAHRTION: I here0y attirm ihat I have a cehilicate ot consent ro self�insure or a cenificate of workers'
Campen5alion Insurance, or a certilietl copY Ihereo� (Section 3800. Lab. C�.
POLICY NO.: E%P. OpTE:
COMPANY:
'� Certiliea copY is here0y lurnis�etl. ❑ Certifietl copy is fileU with t�e ciiy BuildinA �ivisfon.
eate: ApDlicant:
EREMPTION FBOM WOFNEflS' WMPENSNTION OECLHBATION: (This sectian nee0 not �e wmpletetl i� the D¢�mA is for one hunCreO (510�) or less�.
I cetli�y tnat in the peAormance of Ihe work for which Ihis permit is issued, I shall no� employ any Derson in any mann¢r so a5 io become
subleq lo Ihe Work^rs'^ pen aiion Laws ol Californid. / A �'�
I_�, i i..
�eate�. %�� -� Signalure.\/��"��l� �
NOTItE: If. alier making this Aeclaration, you should become subletl to �he Workers' Compensation pmvisions ot �he Labor
Code. you must �ohhwith comply wit� such pmvisions or ihis permii shall �e tleemetl revoketl.
CONSTHIICTION LENDING NGENCY: I hereby aftirm Ihat �here is a cons�mc�ian lending agenry �or �he pedo�mance of t�e wark for
whic� t�is Oermii is issuetl (Section 3097. Civ. C).
LENOEfl:
p0�FE55:
OWNEfl BUILOEP UECIAHATION: I herehy alfirm Ilta� I am exempt �mm �he Con�rac�ors' Sta�e License Law for Ihe �ollowing reason
(Seclion 703L5 Business and Pmlessional Cotle- Any ciry o� counry whic� requires a permii to conslmct, alter, impmve, Oemolish, or
repair any simcture. prior la its issuance. also requires the aDPlicant tor such permil to lite a signea statement ihat helshe is IicenseA
. pursuam to Ihe pmvisions oi the ConVacmrs' S�ate License Law �Chap�er 9(commencing wi�h Section 7000) al �ivision 3 of Ihe Business
� antl Pmlessions Cotle� or �hal he/s�e is exempt therelmm anU Ihe basis tor �he allege0 exemp�ian. Pny violation ol $ection 7031.5 6y
any ap0�icant br a permit suble��s ��e applicant lo a civil penalry o� nol mo�e ihan live �untlred Oalla�s (SSW).
I, as owner oi the OroDerty or my employees with wages as iheir sole compensation, will Ao �he work, anA ihe
❑ slmclure is not imentled or ollered br sale (Seclion 7044, Business anA Professional Cotle: The Contractors' State license Law
tloes not apply to an owner of a D�openy who �uilds or improves thereon, and who tloes such woln himself/hersell or t�muAh
his or her own emplayees. pmvided ��a� such impmvemenis are not inten0ed or ofieretl lor sale. I�, howevei �he builtling or
improvemen� is soltl wi�hin one year of complelion, the owner will have �he hurUen of Dmving he/she did no� 6uild o� improve
lor ihe pur0ose ol sale�.
I, as owner of the property. am exclusively tonirac�mg wi�h licensee conirac�ors �o constmc� the pmlect (Section 70A4, Business
❑ and Pmlessions CoOe'. T�e Caniracrors State license Law does not ap01y lo an owner of pmperty who hwlds or imD�oves ihereon
antl who comracis lor such pmlects wiih a contractor(s) license pursuam m t�e Coniracbrs' State License Law). I am aware
Ihai prool o� Iheir Worker's Compensa�ion insurante shoultl be Dmvidetl to me.
}� � am exemp� under Sectian: HP 7 O 9 4 B. 8 P. C.
m� fm/a �eason: ALL WORK HY OWNER� �
e: 7 � � ^ � Owne�i����
I tla hereby cenily iha� I am aware o� and untlers�antl �he requiremems o� Cali�omia Heal�� antl Safe�y Cotle Sections 25505. 25533, antl
2553a antl thal I or any iNure huilAmg occupani will/will not (circle one) neetl �o comply wilh saitl s�a�e codes and �he requiremeNs far a
permii lor conslmctmn or moditicaiion imm Ine Air Oualiry Managemeni Oistricl. fleSiUen�ial consiructian appliwtions are exempi �mm
Ihese pmvisians.
Oale: Applicanl
I hereby ceridy I�a� I have �eatl Ihis applicalion antl s�aie thal ihe above in�orma�ion is carrecL I agree to comply with all ciry and counly
ortlinances antl slaielawsrela�ingto building cons�mc�ion antl here6y authorize representatives oi�his ciry�o enlerupon(he a6ove�mentione0
pmOenY �or inSPec�ian1urPose_/ ` �r4i�� . "���l.nCn�% ' �i
c /l// iC..,o.!/
te'. � � '/ � Signawre: �, �'�-�� �c��%
oriver's �icense or Sociai Securi�y p:
i6ai�c6 White—BuilOing; Green—Cotle Enlorcemem: Canary—Applicant: Pink—Revenue: Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 066730 PLAN CHECK NO; - N
CONSTRUCTION TYPE: V—N PERMIT TYPE; PLU
JOB DESCRIPTION : REPLACE GAS LINE
PERM NO: P 066730
GOVT: N SUPP: N
SQ FT:
PURPOSE: OTH
CLAIM C�ALUE: 200.00 CALC—C�ALUE: GROUP OCC: R-3 /
COMMENTS• SMOKE DETECTOR RE�UIRfiD PRIOR TO A FINAL
*x�t�x�***�ri�**+ti�i��t*�r�r**x�***+ri�* **�rx�****x��t**�+r*�t�r*�t***+�i�**�r�r***+c-�t�c-�r**x�***f�*+�+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 REAA; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL; 13940407 ZNE: REF NO:
PLANNING Nt5'PES>
i
x�+r+rx*x-�t�r+c�rtx�x-+��r�r**ir*�r+r**�rx��r**�t**��r��t*�r�-�-+t�t�r�r**x*�*f�**x�*x�***�r*�+�**x�********+�rt*�r*+c�
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 HY DATE:
HUILDING APPROVED HY ; DATE:
APPLICATZO�NiSSUED HY: ' DATE: 7—/'� L
iEiEiEMitiElEiEiE ifilifiEiEaflklEifiEiE1E fliFiElEfElEififiEiE %iE
iEiEiElElEkiEliiEklE�EiEiElfiFiliFifitiE3EifiEifiEiEiE4lfiEifiEitdEiEiEif1E iE 1FitiflEiEiEiEiFifkiEiEMiflflEiElEiE�EifififiEifif�ElEjfififififit3liEif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
PERMIT BLDG PMT PLUMSIN�G� ELECTRIC MECI-IANIC FIRE SMIP/RES GRADING
zsx
PLAN .
ISSUE FEE 20,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 5.00 20.00 0,00
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
25.0�
TOTAL
25,00
SMIP/NON—RES
PAID DUE
25.00 .00
25.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
1E iE iE 1t fE 1E fE iE iE iE �F 7E it iE iE iE iF 7t 1f �! 1E iE if if iE iE 1E iE it it 1f iF it i! iE itlE 7E k �f if iE iE iE if if �E if 1! iE iE iF k 1F iE i! iE if iElElk 1E iE if jt iE it iE 1E iE it 1E if iE 1f iE if if iE
I N D I V I D U 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
PLU 1 GAS PIPZNG SYS OF 1 TO 4 OUTLETS 5.00 5.00
END OF FEES
ai �p1`+3cb4-00253`b4 7 �1T 24,pp
6ATE: 04l07/94 TIttE: O�ep3
CONSTRUCTION AN� PLANNING POOL PA ; '
APPROVALS Permit# Date inspector APPftOVAIS Permit# Date Inspector
i
1. Temporary E4ectricaV Service or Pote 52. PooV & Equipment Location - "
2. Soi1 pipe-Undrgrnd. 53. S[eel Reinfiorcementi � "
3. Efecirical Condult Utility-Undrgrnd. 54. Fo�ms -
4. ElectriCai ConduiY�Undrgrnd. 55. Electrical Bonding
� 5. Steel Reinforcement� 56. Rough Piumbing & Pressure TzsC-'
- 6. �Eiectr(caIUFERGmd. 57. APPROVALTOCOVER�GUNITE
. 7. Fooiings 58. E�ectrica! Conduit-Undrgmd. "
8. FoundBtion 59. Gas Pipc, O Undrgrnd., Test - `
9. bb'ater Pipe-Undrg: nd. � 60. Backwash Lines, P�Trap, O Undcgrnd. ��
70. Structural Ploor SYstem � 6S. APPROVAL TO DECK ' � .�
i i. Proper.Y Seever Line,& House Connection 62. Baekwash & Recep;or�Final
12. Sewer Cap 63. Heater & Vent�Final ��
73. Roof drains 64. Plumbing Sys.em - Pinal nr �.
14. Rough Plumbing �� 65. Electrica6Final .
15. Rough Electrica6Conduit 6fi. Solar System�Final �j ;
16. Rough Electric Wiring . 67. Fencing & Access ApVroval � �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
78. Rough ElectricabT Bar Ceiling 69. POOLiSPA SYSTEP,9S FINAL
19, Rough Heating & Air Condizioning pIRE DEPT. REQUIREMENT I
20. Rough Factor.y Fireplace ', -. - qppppVAlS• �•"'Pernnit?f
Z.
21. Ducis, �n Structure _ � . � , �� . � � ,70. Undergrpund: Hydro � �
22. Ducts, Ventlating • '_ ' �77, product_Piping �GSs C��OiI
23. �Gas Plpe`Rough &'Tesc , ;� �72 Undergrouod Flush . �
24. Roof Framing' - -• • - . " 73.-Undergcnd.Sto��geTank �Gas ❑G:!
25. Aoot Sheath(n9 - .� �� 74. Ovarhead Hydro � - �
26. T�Bar C-eiling (StrutturalY & RAonocoat � ' -' 75. Dry Chemicai ` ' ' '
i
27. F;amzand Flashing .. � 76. DryStanCpipe �-� � ^'
28. 2a,hing & Siding � _ � . _ • • •� 77._-F;XEO SYSTcM F'INAL' '
r
29. Insulat�on " � �. . ' I � � 7$. FIRE PREV. FiNQL , - �
30. Dry�vati Naiiing � � I � • i� �' •HEALTH�DEPT. REQUIREMENT
31. P�aster Brn�nn Coat i ` 79.'�FINAL I'NSP�CI'ION " �
i. --�-;- _.-
32. Elzetric:ai Power Meter-=inai � � �- �, •80. �FQOD CER1lFICA7E ISSUED
33. �inai Electn.c . ' '� � ' � �'�Not'es: - � � • ,
34. �Final Neating & Rir Conditioning.- ` � � I �, � ,� ! G+�i� � �0 ' � �/
cb-! °- _�r�C��'__[:���%=�-� _':�
35. Pinal Gas Pipe-Test S,-(� a' ` J' � i.i �!L _ r�.-ly�
'� l %�7!�. �.- � .
36. Hootl o� Canopy _ � . � : ' � .. -
37. Final Factory Fireplace ' '' , . ;
i
38. Final Plumbing � � • - ' . - .
i
39. Water Service-Final ' � ' r � �
40. Gas Szrvice-Finai . , . � ' !� �
41. Solar QomesticPinal �• • � ' � ' � �_ .
42. BackflOw Preventer ,"� j I' . � , �
43. BackftOW Irrigation � �
:44. LandscaPe i�rigation System, ; , . , - - � . .
45. Sound Aitenuation � ' � � _
,� . i
46. Handicaq Ragulations � - . . �
47. FINAL STRUCTURE & BUIIDING � "' �-�
I�� '
48. FINAL PLANNING � � � � � � -
1 ' ' -.n
49. Electiic Release to Edison +� � �
50. Gas Release to Southem California Gas Co r. �!. . �� •
51. CERTSFICATE OF OCCUPANCY . .
No. Dace
cr
•� �'�•
Applicant to fi11 in all soaces exceD� tnose within heavy Doraer Ilnes ana sign al1 aoo�oo��ale eeclarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT
Project Address �� �O� �.. �� �, �• 92626
Applicant's Mailing Address
Owner'sName �'•�'s. FT'aT1�CW. Wit�e�'k Phone 557-9727
Addreu 2F�7 Furopg Dr.. Costa :�h�. Ca. 92626
Arch/Eng. Licenu No.
Address
Contracror's nlame �a�� �Othe.is pho�e 54(r1653
Address (mailing) Z952 Centurv Place, Cnsta Mesa Ca. 92626
9
City License No.O(159Fi3
LICENSED CONTRACTOR DECLARATION
1 he�eby alfirm [ha[ I am licensetl un0e� provizions of Cnarter 9(commencing
with section ]000) of Division 3 of the Businezs antl Professlons Cotle, antl
my license is in tull torce antl etiect. �ocn�
License Class Li ens No. Z`IOIJI%'�
Date7—�T�-G'-i� Siqnature
WORKERS'COMPENSATION DECLARATION
J hereby af/irm that I have a certificate of con5ent [o z¢If-insure or a certifica[e
`:,;f Worke�s' Compensa[ion Insurance, o� a certitietl coOY thereot (Section
^taoo, �o. c.� hC15-4821-84 co,,,a,,,v lhti�ard
�Policy No. .
BCertifietlmpPyj'S�hletlbwitOrthehc�tY.�i� Itl1I� Di�y n 0
Date �L'�3'HS APPlicant��./�A1/�/e..Q-��€'✓✓
EXEMPTION FROM WORKERS' COMPENSATION DECL A N
(This section neetl not be com0�etetl if the permit is for one huntlretl (E100) or
less).
I certity tha[ in [he Oerfotmance ot th¢ work for which this perm�t is issuetl, I
sM1all not employ any person in any manner so as [o become subject to the
Workers' ComOensation Laws of Califomia.
Dale Si9natur¢
'NOTICE: H, atter making this tleclaration, you shoultl become subject to the
Wo�ke�s' ComPensalion provlsions of Ihe Labor Cotle, you musi tormwitn
compty with such provizionz or this De�mit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affl�m that [here is a const�uction lentlin9 agency tor the perlormance
of ihe work for which this permit is issuetl (Sectlon 309] Civ. CJ
Lentler's Name
LentleYs Adtlress
OWNER BUILOER bECLA0.ATION
1 nereby attirm that I am exempe trom tne ConVacior's License L.aw for the
followin9 reason (Section 7031.5 Business antl Prote55ional Cotle: Any clry or
county w�ich r¢qui�es a permit [o con5truct, alte�, improve, tlemolish or repair
any structure, prior to its issuance, alzo requlres Me applicant tor such permit
to tiie a siqnetl slatement that he/she is licensetl pursuant to the provisions of
the Contraclor's License Law (Chapter 9(commencing witM1 Section 7000) ot
Division 3 of the Busine55 antl Profezsions Cotle) or that he/she is exempt
'�eretrom antl the basis fo� the alle9etl exemption. Any viola[ion ot SecHon
)3L5 Dy any applicant tor a pe�mit Subjects [he applicant to a civil
enalty of not more tnan (ive huntlretl tlollars (y500).
b I, as owner of tne property or my employees with wa9es as their sole
mmoensation, will tlo the work, antl the sVucture is not intentletl or oHeretl
for sale (Section ]044, Business antl Professional Cotle: The Contractor's
License l.aw tloes not apply to an owner of a properry wno builtls or improves
thereon, antl wno does such work nimself/herself or throu9h his or her own
employees, provitletl that such improvements are m[ intentletl or offe�etl tor
sale. It, howeveq Ihe builtling or improvement is soltl wilhin one yea� of COm-
pletlon, the owner will have the burtlen Of proving he/she tlitl not builtl or im-
p�oveforthe purpose of sale).
❑ I, as owner o( the oroperty, am exclusively con(ractlng with licensetl con-
Iractors to construct the Projecf (Se<tion 7044, Business antl Professions Cotle:
The Contractor's License l.aw tloes not apply to an owner o/ property who
builtls or improves thereon, antl who contracts for such projects with a con-
Iractar(51 license pursuant�to the Contractor'S License Law). I am aware that
Oroof of lheir Worker's Compensation insurance shoultl be provitletl to me.
❑ I am exempt untler Se<tion B. & P. C. Por this reason
Date Owner
I hereby certily that I have reatl tnis application antl state tnat the above
information is rorrect. I agree lo com0ly with all city antl county ortlinances
antl state laws relating to building consVuctlon, antl hereby authorize repre-
sentatives of this city J.o let upon Ih¢ above�mentionetl property for
inspection p r o s. {�
Signature G</ �f-+ .� O t L—/ 3^fi�'
Orivers' License or SS� � �'�
TVPE OF CONSTRUC710N LJ NEW IJ ADD LJ ALTERATION Ll REVAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p #
DESCRIPTION OF WORK/USE OF BLDG.
S Main Buildi
E
TVPEOFPEHMIT GRAOING FOUNDATION STRUCTURAL T Ffont
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAI B Rear
❑ OTHER A
PROJECT DESCRIP710N 5a. FT. oCCuvnrvcv C Right
CONSTRVCTIONTVPE VALUATIONS g Le(L
ZONE GRADING CV.YDS. ACRES P��g, Ref. #
Remarks: Planning Notes:
Sink
Preventer
Irrigation
�rinking Fountains
Floor Drains
Floar Sinks
ud5 SClVICC Ol1IIQL5
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - SVuctural
Duct - Ventilating
Exhaus[System ❑ MW[iple
Firep1/Fact. Blt. ICBO �k
Heating System & Ducting
1�0.100,000 BTU 0100,000
Reinspection Fee � $15
1F 0865-46, rev. 10/84 Wnite - Builtlinq; Canary - Applicant; Pink - Accountinq; Goltlenrotl - Asse55or
Showers
Service Sink
Sewer Cap
Sewer Connection
$Olar Collectors
$olar Pipinq
Solar Tank
Swimming Pool w/Spa
Urinel
�il�3LQf C.�OSCI
Water Hea�er
Water $ervice
Auto-Wash
Laundry Treys
Issue Fea
Hood or Typel �
Canopy Type I I ❑
Rc;rigeration System
�0�100,OOOBTU ❑100,000
System Repair/Alteration
F ire Dampers
Registers
Issue Fee
$ 3
FEES
S 3
Auromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Elec[ric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 00.5 KW C
Fee
�6a� 2/15/85 ii.o� ��
ZO�e
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors �0.1 HP 01 h- 8
Inc.Solar �9-15 HP 016-75+
Microwave
Pole Light
Range
; $tanding Sections
5-15 KW Trash Compactor
$75 Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
8uilding Approved By
Aooliwtion Issued Bv ��
FEES
$ 3
Z
O
N
I
N
G
H
E
Q
M
T
5
SUMMARV OF FEES � '
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT ,Q_Ky
ISSUANCE $ �T���
PLUMBING $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM S
MECHANICAL $ � TOTALFEE $ ��•�
VLAN CHECK Z5% $
✓
CONSTRUCTION AND PLANNING - - POC � SPA ,
APPROVALS'- Permit# ����� Dzte Inspector AppROVALS Permit# Date Insper.tor
7�. Temporary EIE:ctrical Service or Pole � 52. Pool & Equipment Location �.
-' 2. �Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement .�
� 3. Electrical Conduit Utility-Undrgmd. 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 . 58. Flectrical Conduif-Undrgrnd. _ � ,�
� 8' Foundation 59. Gas Pipe, O Undrgrnd., Test
; 9. Water Pipe-Undrgrnd. . � . 60. Backwash Lines, P-Treo, � Undrgmd.
10. Structural FIoOr System -� � 61. APPROVAL TO DECK � �
11. Property Sewe� Line & House Connection 62. Backwash & Receptor-Final
. 12. Sewer Cap � 63. Heater & Vent-Final
73. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbing - . - . 65. Electrical-Final
15. Rough Electrical-Conduit B6. Solar System-Final . �
76. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .
2�. Rough Factory Fireplace APPROVALS. Permit#
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
� 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑�Oil�
25. Roof Sheathiny 74. Overhead Hydro '
26. T-Bar Ceiling (5trucwraq & Monocoat 75. Dry Chemical �
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailinp HEALTH DEPT. REQUIREMENT
31. Plaster Brown Goat , 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
33. Final Electric Notes: •
34. Final Heating & Air Conditioning 2 p�l [„fr./) �
35. Final Gas Pipe-Test
36. Hood or Canopy � "
37. Final Factory Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
�
42. Backflow Preventer
43. Backflow Irrigation '
44. Landscape Irriqation System .
45. Sound �Attenu�3tion
46. Handicap Regulations , '
47. FINAL STRUCTURE & BUILDING .
48. Special Requiremenis Completed . �
49. Electric Release to Edison , ��
, ,
50. Gae Release to Southern California Gas Co , � ' �
51. CERTIFICATE OF OCCUPANCY _- . � . _ . �
No. - � Date • . � - .
,
AOP��cant to till in all spateslxceDt lhose Within �eavy Oo�tler lines anE sign all apPropriate tleclaralions.
ICITY OF COSTA O�NS1TRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. A P# Zone
� ProjectAddress ���I ��y^�'>��� - n r �i�s�
AppliCanYS Maili,n�g^ pqddBss !W� `�'A S � SfN, 1: U�"�L/� TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E Main Building: AcctiSory Building: Z
Owner's Name -"�1^• ���Y��L� phon�—•—f � CONVERSION ❑ DEMOLISH ❑ O�T R T Front Q
� 97Z DES RIPTION OF WORK/US F B G. �" I B Rear N
q��ress 2k 7l% � v 1�0{�A " P ' i /+ I
TYW OP PERMIT GRADING FOUNDATION STRUCTURAL '� C Right N
Arch/Eng. License No. K G
Address ^ ' , � TENHNT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL S Left
Contractor's Name1V�- ���� �� Phone ��OTHER ! Ping. Ref. # Parking Req./Provided E
Address Imailingl �Z- � J] �'�c. j�'����� PROJECT DESCRIPTION 54�. FT.+ OCCUPANCv � 9 M
� CONSTRUCTIONTVPE ,y F� VALUATION$�7�%% Plannin Notes: T
CiLyLiCenSeNo. ZONE GRADINGCU.VDS. ACRES
LICENSED CONTRACTOR DECLARATIO , S'
I hereby atfirm that I am licensetl untler provislons of Charter 9(commencing 0.emarki:t� `r, r (/
with seCtion 7000) of DiviSion 3 of the Businesi antl Protessions Cotle, antl
my Ilcense is in lull force antl ettect, 'j� G�j� �
ELECTRICAL FEES
License C�i {s License No� �+✓� `� PLUMBING FEES /automatic Washer Tronsformer ❑ 15-50 KW
Date�`� 1 5'9 t
WORK�RS'COMPENSATIONDE LARATION ConStructionPolESub, ❑50+KW
1 he�eby affi�m [M1dt I have a Certificate of consen[ to self-insure ot a ce�tifiGate Bar Sink $hOwElS
Workers' Compensalion Insurance, or a certifietl copy thereof (Section gackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps
0, �aD. C.)
roiicy No. comoany Backflow Irrigation ge�,,,e� yP Dishwasher Meter ❑over 100 amps
eCerqfietl copy is hereby furnishetl. Dryers ❑Gas ❑EI¢ttric Sub Panel
Cert��ietl copy I5 tiletl with the city Builtling Division. BdthtU65 5¢W¢f COOfI¢cti00
Dace .aoailcanc Fan Motors �0.1 HP 01 X� B
EXEMPTION FROM WORKEpS' COMPENSATION DECLAfiATION Clariiien $plarCoNector5
[This section neetl not oe comoletetl if t�e permit is for one huntlretl (5100) or F.A.U.
iess). Dishwasher Solar Piping Ina Solar �g-15 HP �16�15+
I cxrtify inat in tne periormance of Me work for Which thls perm�t is issuetl, I Pix[ures
shall no� employ any perzon in any manner o t become subject to Ine Drinkin9 Fountain5 Solar Tank Microwave
Workers• CompeIl sacion Laws of Cafitornia
Date Q�_°�C�`S Si9nature Floor Drains Swimming Pool w/Spa Device Bpxes Pole Light
NOTIC�; �(, afte� making this tleclaratio , you ShOUItl becom¢ subject t0 the OUt1Ct5
Workers• Compensation provis(ons oi t e Labor Cotle, you must forthw(th FIoOr Sinks Urinal Range
comp�y with SucM1 provl5ion5 or thi5 permit snall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV GaSServiCe OUt12L5 Switch2S Si n
Water Closet 9
I nereby atfirm Mat t0ere is a construction lentlin9 agency for tlle pertormance
of U�e work for which this permii is issuetl (Section 3097 civ. CJ Interceptors Water Heater Garbage Disposal Standing Sections
Lentler's Name
Lentler's Atltlress Kitchen Sink Warer Service Generator �0�5 KW Q5-15 KW Trash Compactor
OWNER BUILDER DECLARATION
I hereby affirm lhat I am exempt trom the Confractor'S LlcenSe Law fOr tM1e LdVdtOri¢5 AutO-WBSh
following reason (Sectlon 7031.5 Business antl Professional Cotlo: Any city or
munly whlch r¢quir85 a pe�mit [o const�uct, alteq improve, tlemoli5h O� repai� P—T�dp LdUndry T�2y5
any SlrucWr¢, p�lo� to Its i55uance, also requires th¢ applican[ �o� Sucb p0rmlt
to /ile a signetl statement that he/she is licensetl pursuant to the provisions oT ROOf Dfains
the Con[ractor'S License Law (ChaOter 9(commencin9 with $eCtlon 7000) ot
qivision 3 ot the Business antl Professions Cotle) or that be/she is exempt ReinSpeMion Fee $15 luue Fee '
,+,,i;elrOm anC !he basi5 tor the allegetl exemplion. Any viola0on of Section $ 3
t-.:.'��'1 5 by any aO���Ganl tOr a permit SUD�ectS ttte appliCanl tD a Civil
":ulty of noe more than five huntlretl tloliars (E500). 3 DEVELOPMENT SERVICES REQUIREMENTS:
� U I, ds owner of the O�operty or my emp�oye¢5 with wages as their sole RejpSpetti00 F88 $1$ ISSue FBe § Zoning Appray¢d By �et0
compeqsation, will tlo the work, antl the struc[ure is not intentletl or otferetl
tor sale (Section 7044, Businezs antl Pro(essional Cotle: The Contraclor's MECHANICAL FEES Building Approved By Date
LicenS@ �nw tlo¢s not dPD�Y �o an owner of a prope�ty wno builtls o� irt�proves
IhereOM1, antl who tloes such work him5¢If/her581f o� Ih�ough hls o� h¢r ow� AppliWtiOn ISSU9d By _!w�_
employees, p�ovitletl tbat Sucn imA�ov2ment5 arC not Intentle0 or otfe�etl for BOiIEf HOOd 01 TypC I ❑ �dt
sale. II, however, the Duiltlin9 or impmvement is mitl within onc yoar of com- Canopy Type I I ❑ SUMMARV FEE
pl¢IiOn lhe owner will nave the burtlEn of proving he/she tlitl hot builtl or IT- DuCt - UndCf i�i�0U0d �
�rove �or the purpose ot zale). BUI LDING PERMIT $��9,_,._vd SMIP $
LJ I, as owner ot the property, am exclusively contractlng with Ilcenzetl con- Duct -Structural Refrigeretion System PLAN CHECK
Iracrorsto construct Ihe P�ole« (Section ]044, 8usiness antl Professions Cotla: $ PERMIT
Tne Concractor's License Law tloes mt apply to an owner ot property who Duct- Ventilating ❑0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $
builtls or imDroves thereon. antl who conVac[5 tor sucit oroi¢CIs with a mn-
tractor(s1 Lcense oursuan< <o �ne �onvactors License Law). I am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteration P�4N CHECK 25°k $ ENERGY P,C. $
prom ol tneir Worker's Compensation insurance shoultl be provitletl to me. ELECTRICAL $ GRADING $
❑ I am eaempt untler Section B. & P. C. for this reason Firepl/Fact. BIL �CBO �k Fire Dampers MICROFI LM $
PLAN CHECK 50% $
Date owner Heating System & Ducting Registers MECHANICAL $
I hereby certity that I have reatl this application antl state that the above ❑0.100,OOOBTU �700,OOOBT TOTAL FEE $�
intormation is correcL I agree to tomply with all city antl county ortlinances PLAN CHECK 25% $
and ztdie laws relaNng [o builtlin9 construccion, and hereby autboNze repre-
sentallyes ol tM1iS o¢ntef upOn the abpve-mantionetl prOpelly lor
inspection Purp s.
Si nat r¢ Date '�' i
Dnver=• License r 55 4f Reinspection Fee $15 laue Fee $ 3 Q1T�Dii-r�_IU�G��4�111 ��: +�",'' j
D�,.ts GS/lu/:,9 TItiE: ?''>:,,_ y
0865-46, rev. 5/BB Wnite - Builtling: Canary - Applicanh Pink - Accounting; Goltlenrotl - Azsessor
C NSTR,yCTION AND PLANNING POOL 'PA
• Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
1. Temporary Electric8l Service or Pole, 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. �� . �� 53. Steel Reinforcement
3:IElectrical Conduit UtiliTY-Undrgrnd. � 54. Forms '
r' n
4"Electrical Conduit-Undrgrnd. 55. Electrical Bonding
.�
5. Steel Reinforcement ,' 56. Rough P{umbing & Pressure Test
6. Electrical UFER Grnd.' ' 57. APPROVAL TO COVER-GUNITE
i
7� Footings - 58. Electrical Conduit-Undrgrnd.
8.' Founclation .! ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. ,
10. Structural Floor System ', 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains , 64. Plumbing SYstem - Final ��
14. Rough Plumbing 65. Electrical-Final
75. Rough Electrical-Conduit 66. Solar System�Final
76: Rough Eleetric Wiring 67. Fencing & Access Approval
17: Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica6T Bar Ceil°ng 69. POOL/SPA SYSTEMS FINAL
79�.'Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
Y
20. Rough Factory Fireplace �s, APPROVALS Permit #
21. Ducts, in Structure �-,i 70. Underground Hydro
22. Duc[s, Ventilating .� ,.• � 71 . Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test . 72. Underground Flush
24. Roof Framing • �', 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing ' -� 74. Overhead Hydro
�
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame arid Flashing � 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
.
29. Insulation �.'� 78. FIRE PREV. FINAL
30. Drywall Nailing ,. - HEALTH DEPT. REQUIREMENT
�-
•'r
31. Plaster Brown Coat �� 79. FINAL INSPECTION
. _-.
32. Electrical,Power Meter-Fina�; 80. FOOD CERTIFICATE ISSUED
33. Final Electric `�� Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final - .
41. Solar pomestic-Final
i
42. Backflow Preventer ' � � �
43. Backflow Irrigation ' �
44. Landscape Irrigation System ' i�
45. Sound Attenuation ` '
/ _
46. Handicap Regulations �i
47. FINALSTRUCTURE&BUILDING `�' pCj �•
u�
48. Special Requirements Completed
49. Electric Release to Ediso�
50. Gas Release to Southern California Gas Co !" �
�
51. C�RTIFiCATE OF OCCUPANCY I
. ` a-
No. Date �' :
l0 2 � �
' <
�c,`v� �� �i qF` ° °q�,,1 y' 5d ,i-nas�- ° ^��re ,/+ n �7
2 � �: �Sa����LUG� �5�'Svr'"iSn��;U���t.';:o� e(cSoutJ��e�z �aLifoinia, Jnc.
_i9 � I' O ��
' 4' I i ���I, � r.0. 2^X e7 , 3J1^ A!F.F02T WA`! . l i�'6 PFACI-'. CP.I:F. SCBCI . �21?� �26-33>5 .(713j 6?6-2395 .(%Nj B2B�6!37
' �.4^�Zcc=�i,,.�S:ar' 22nNCu CciCEi:
IF�I:frJ I51.. cr� 1[. .�n� .?.� R❑.. eie�lna
aoe �
s . n..c,��. .:m3 7' �
( I I 5J 4a�5 ��% '���� .q A elil, aLE01 �21]� l36E386
� � �� F�
�< ��
August 20, 19%6
Examina4ion: 76-5135
GUNITE
COMPRESSION 7E5T5 O�I ��4?:����-"r CYLINDERS
?oS Henderson
_78i7 San Rafael.
rountain }'a11ey, Calitornia 90;08 ��.y/ �
./ �PJ
�-?c,Jrcr s���?ruiz,;c root,
q�;p2�;� 2907 �uropa, Gcstz `iesa, Caiiferr.ia
sFr�npLE FROtrt ? from Deep end f_.00r (C�1. 1 S 2) 1 from End Bond Beam (Cyl 6)
FFCMIT'.CT . CONTRACTCR
ENGI4CER
[i. C. =id2IIl$
k11X
DA7E CAST
Dt1TE TESiED
CY11ivG:R h0.
COR9PRESii�P1
TOTAL 10AA, lBS.
POttP�a'v5 FEF. SQ. IN
3.7
8-13=76
8-20-76
'1
7 Ray s
si,000
�.565
Ber�;e Pools
su=.wNreaaea --� -
Gunite linlimited
SPECI"rIED
57kE�7GTti
SLUiv1P
8-20-76
j,l?
7 Days
6a,000
2,405
2,000
8-20-76
;l6
7 Days
82,000
2,900
COFAPiIAid�E 7 llay tests. cempl.�� »ith specificatio.^.�.
MACE 6Y DEtIVERED BY RFCEIVEO ON
CYLIND�RS i,e�r Bob ilencerscn 8-16-76
DIS�i18J71011:
fiob Her.derson - 2
Cvsta Mesw bidg. Dept.
��i? !�IP'G Sr�f��' �EPT
.ti��� � u '`'`
��v�
.���L 11E✓OR�S ARE $VCI�IT�EO A.� TN[ CONFIOCNTI/�L fPfJl`CPT� CF CII�NT'}. AVTMOp:21T10N fOR VVC'_ICnTION O� OV(! RCCGVT^v, COlICLUSIONS. OR ER�
-R�CT'. �RJ�' O� ✓Ec.nwa�rvG ,-vEN. IS PCSCFVEO P�rvJlrv,^� CVn Wfii'.-EN apvRO'.'w� <5 i. Y.VTUnL �`.�CTECTIOH TO CLIENTS, THE FUOLIC /.IIJ OVRSElVr9,
3? O-: Z
. .
REPOP,7 OF INSPFCTIOIi ON Masonry
Conc e
BILL 70:... .
Address:
OutiER:
PROJECT:'
Address:
Archltect:
Address:
��-�i GU.�.�,�.7'��C-E.�ee . r� �
.�tci-�-w. /�' oa-C � R �y/�-� N o . �.r5 �/ %
?.Po �c�cs-,�eC. �'i Pernl t No, t� � 3 6 3 .
0
Con[ractor; ,���p�-Q�
Address: ��'�, �,.�a�
Englnecr: (; /dF�.r,.,�_ . .Suhcontrattor: /,�.,,,, �„ �„�Q,,,.,,�,�
(Gun 1 te , ,
Addr�ss: �,�,�� /`��„�J N�sonry or Q�,.� �,�,,,r-,
/7 � Concrete)
lnspcctor:. �A,iQ���Q�„� AdJrr_ss:
Hix Used: 3• %
$lump, Inches:. - , �
Admlxcure: - • ,
Desl9ned Streng[h, P51: Lor�
{nspcctor: ,����.,�,,,
Rebar:
Brlck;
Block:
The follo�a►ng Inspectlan was porformed ►n accordance Hlth tho approved draxings. •
Cu.Yds. No. of , •
OATES ' Plated CY1• , Remarks
ti
. /..i - 7 � 3 .� �_ �irr.o ' ..�, oa-e .L�ewfQ a�.,,.�.Q�, �Z,t�Rr,a �{[��� Lc-a-/—
- ��---���-�-t���;,
Lop�es of Repores to: (INDICATE 11HICN BLDG. DE?T
330-�
6 FUR�tI$N ADDRESS OF ANY NOT LISTED)
owrrEx PACESETPER WEST JOINT VEN`IURE DATE OCT 2 3�96p
JOB ADDRESS 2$07 Europa Ave. � BUILDING PERMIT N0.174
GENERAL CONTRACTOR [��OS Land CO. VALLTE $ 18�177.00
AP No. 139-4o�+-a LOT Q7 TRACT t�g49 FIRTi ZONE DESCRIPTION OF WORK R2S
I' -"�CTIONS I5ignaturel DATE GROUP TYPE ZON�
: ,( /�/ / -/t/�.] PERMITS I;
�__ � t^—�--i' SUBCONTIiACTOR ,,.m--i—���
1
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OCCUPANCY
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MEBA. CALIFORNIA
For Applieant to Fill In Complefely
TYPE OR PRINT
BUILDING ��O G/ i O A
A�DREBB I'-'V �T
COSTA MESA CALIF RNIA
� ARCHITECT
i� 6 No: K� �'6� �
V/ i/� I NO. OP BLp08.
■ 86TBACK LINe
DESCRIPTION OF WORK
BUILDING NO. OF
SIZE � �D ROOMS
EXTERIOR WALL ./�i li //1 I ROOF
I XHHesY ACKNOWLHOOB TNAT 1 X�VE HCAD TM19 APPLIGTION
ANO 9TATH THAT THe ABOV! IB CORRECi AND AORHB TO COM-
PLY WITN �LL CITY OROINANCEB /�ND 8TAT6 LAWC IiBOULATNO
BUILDINO CONBTIUCTION. /�
81GNATURE OF��1��� ��Vp .��J �
�AUTHORIZED AGEN'//VUI "[.Gv.v/ ���/ i I/�(/'/ �
� E RECE�VED
OCT 1 1962
FINAiVCE DEPT.
CITY Of COSTA MESA
APPL4CAT{ON FOR PERMIT
BUILDING
For Office Use Only
HBCHIri No. ve QCOtlO.
HEC81VFy BY I O/�S, N O DATH 188UHD
�c� � � '� �CT 2 3 75
BUILDING ��O
ADORE65
COSTA MESA. CA ORNIA
FIRE '/
ZONE TYPE V GROUP � A
APPROVED
BY DATE
ZONING
zo NO.OP .7 uae or ne�. �.�,/q ��,
�.�, I PUNe [� I BII�LDINO �y/4�/ p�
.L
LE6AL �. , 7 � y.3 �
oesca�rriox /'
A.P.NO. I3/ � 7Oy� O/
YAROS EVES
APPROVEO ALLOWED
ICBNTER LINE BT.)
FRONT y� FT. �� I_N.
R. SIDE � FT. W.
L. SIDE � FT. IN.
REAR �� FT. '— �N.
APPROVED . /n //�y/�i
BY C(��Jqy/JT _ DATE
i6S6 ",�/ ,� "�u �Jl -,P u`'Q-l�
THH LMOUNT 9XOWN UND8i1 VALUATION 9 POR TH8
PUPP088 OP [6TAOL19MIN0 A PERMIT FEE ONLY.
VALUATION
p PERMIT FEE $ � O• ��
�G �r%% d9 30. °�G
S / PLAN CHECK $
dG
TOTAL FEE $ �O�
OWNER �ITEECK Frank DATE 7_26-76
JOB ADDRESS 2Rt17 Eurnna Drive BUILDINC� PERMIT N0. li93F7
GENERAL CONTRACTOH Beree Pools DESCRIPTION of WORK Pvt
No. 139-404-07 LOT TRACT FIRE ZONE VALUE
�,.�pECTIONS Si nature Date GROUP J TYPE
Pool Location �-- �b� ' SUBCONTRACTOR
Forms
Main Drain
Steel Reinforce
Elec. Bond �
Approval to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines and Recep.
Electrical Final
N�ater and Vent Final �
:r System Final
Backwash and Recep. Final
Fencing Final
Electric
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42363
COSTA MESA BUILD�NG-SAFETY DEPARTMENT
P.0.80X1200 COSY.4MESA,CALIFORNIA92626
For Applicant to Fill in Comple[ety — Use Ink Only
BUILDING �CO� Q�-�`� �
ADORESS Q (
OWNER {�i(Q/CL ��Ai�'�('�'�
MAIL �,� v � . _ _ �
CITY � � 0 �
CANSTFUC710N
BRANCH
ADDRESS
NO.
TEL.
ADDRESS �'.�(>� ,/�+-ooE'�iarsr. V 6 �
CONTRACTOR �Y�Q /'GQ�S
ADDRESS c.il3r ��•!�1`-�/
/� TEL. n/�
CITV s��. .-l�J- ��i NO.C� /7'.
STATE a �o�� 3 CITY
LIC. NO. LIC. NO.
SIZE NO.OF BLOGS.
OF LOT I NOW ON LOT
USE OF }���
E%ISfING BIOG. /"�7 -
Separa[e permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WaRK TO BE PEFFOflMED
n��T ��,n., �o���
sr� .
I hereby acknowletlge that I have reatl this epplication and state
that the above intormeiion Is correct antl a8ree to r,omply with
all laws regulating builtling consVuction, and 1 shall not employ
any pereon in violation of the workman's compensetion laws of
the State of Calitornia.
1 hareby certify thai I am pfo0erly Iicensed as a conttactor under
the State of California Business and Profassions Code, Division 3,
Chapter 9, and thai such IicO�ses are in full force and aftect, or I
am ezampt trom the provisl0�s of tha Stet¢ of California Business
antl Professions Cotle, Divisio� 3, Chapter 9.
SiO�et e of ���/���eOy�� �
Permitt� �[ l�-1) �lJ o
Authorized ABant
N,i 3.�=���.�68��3�"����:�:,5f;.5a
AP Ll Tt N �OR STRUCTURAL PERMIT
REC IV B D TE I DATE S D
i �
/ rj p� ��rj{��y ERMIT NO.
A.P. NQ �/ / ��r (/
BUILDING (+ }'�
ADDRESS a (jU� ` Ll.YO/DY{ � •
TRHCT l0T(i / BIOCK
EW ADD ALTER REP I
�Y
OWNER J / PC C� �
1 /� VAWE �
se tuim % Ga�il� s ` 60
FIRE
20NE YPE GROUP
APPROVED �
BV A � DATE i
20NE/i / INO.OF
VAROSAPPR�VED
MAIN BUILDING
ROM C/L STREET)
USE OF NE
BUILDING
V qRDS APP
2 I "FT D
DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCE�. BLD
VAR.# DATE
C.U.P.# APPROVE�
0
n
m
i
:
SQ. FT. w
THE OUNT SHOWN UNDER VALUATION IS FOF m
THE PURPpSE OF ESTABLISHING A PERMIT FEE ONLV: �
VALUATION PERMIT FEE $ a
� N
ro
LAN CHECK $ "�
'/ ` 0
$ ��.( J TAX $ � LL
/ � V
TOTALPAID $