HomeMy WebLinkAbout212 FLOWER ST - Building Permits0
� CITY OF COSTA MESA �
(,��pMFs'q BUILDING D/VIS/ON
i � 77 FAIR DRIVE, COS7A MESA, CA 92626 • Q14) 754-5273 • Fax p14) 754-4856 • wv+w.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
.���� �
PERMIT NUMBER: B10-00264
PERMIT TYPE B_ROOF2
APN: 42540403
JOB ADDRESS: 212 FLOWER ST CM
Vicinity: REAR HOUSE ONLY
Squares: 1900
STATUS:
DATE ISSUED:
ISSUED BY:
Suife/Unit: ,_
Valuation:
ISSUED
09/09/2010
RMD
$5,000.00
SCOPE OF WORK: REROOF REAR HOUSE ONLY (PERMIT ON FILE #2349). TEAR OFF.EXISTING ROOF MATERIALS INSTALL 2
LAYERS OF 15# FELT AND REROOF WITH 30 YEAR COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE,
APRPDX 1900SF. REPAIR AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED TO JOB�CARD
AND CITY PERMIT. - � � � . , .
OWNER: WHELAN, DANIEL�J '
PHONE: 949-795-9742 . � .
APPLICANT: MCCLAIN; KIM
PHONE: 714-897-1780 �
'- � Address: 2027 DIANA LN - '
- � ." �- City/State/Zip: NEWPORT BEACH, CA� � �
Address: � �
City/State/Zip: - -�-
CONTRACTOR: MCCLAIN ROOFING INC - � �
Address: 12812 VALLEY VIEW STUnit:
City/State/Zip: GARDEN GROVE CA 92845 � -
ARCHITECT:
ENGINEER:
FEESUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
$o.00
$11125
$0.00
$1.00
STE 33
License No.
License No.
� License No. 625013
� PHONE: " 714-897-1780
CELL:
PHONE: �
PHONE:
Unit:
Unit: :
4L PEES $112.25 -
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3I18/2010 - PER CMMC Sec. 13-279
Monday ihru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Dav, Memorial Dav. Independence Dav. Labor Dav, Thanksgiving Dav and Christmas Dav
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia slatutes and related
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must compry with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will resWt in the expiretion of this permit.
CODE/. INSPECTIONTYPE Or1TE INTIPALS COOEt INSPELTIONTYPE DATE INi111RL5
1616 Fixed System Final Pire Prevention 206 Final Mechanical
1266 Pool Spa Final �/ �,, 208 Final Plumbing
200 Final Re-Roof /� ��' �` U � V�'v'� 270 Final ElecUical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm under penalty of perjury one of the follovnng declarations:
❑ I have and will maintain a certificate o( consen[ to sel(-Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, (or the
peAormance of the work for which this pertnit is issued.
❑ I have and vrill maintain workers' compensation insu2nce, as required by
sectbn 3700 of the Labor Code, for the peAortnance of the work for which Ihis
permit is issued. My workers' compensation Insurance cartier antl policy
number are: �•T_
(Ca�ri9r: D IY! I� �)A.�h
(Tnis section need rwl �e mmpeteOGMe perml is value0 at one hunOred 6aNars (St00) wless )
Policy�Number: ��I I ��IIOD'�/�%� � �
❑ I certify that in the per(ormance of ihe work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensalion laws of Califomia, and agree that if I should
become su6ject to [he workers' compensation provisions of Section 3700 of
the Labor Code, I shall forthwith comply with these pronvisinons.
�en V/ f vl /I �
FppGcanYs"SignaWre (j7dle�t
WARNINC`i. FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE IABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby atfrm tha[ I am licensed under provisions of Chapter 9(commencing
vn[h Section 7000) of Division 3 of the Business and Professions Cotle, antl
my license is in full force antl effect.
�t�:'x�r�r/�0%i�il 3 Ciass #� C.3
yC. %�—�-- l J
� �ptiatloisSlgnaWre �Da1-e�.
r.a
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a cons[mction lending agency for the
peAortnance of the work for wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby affirm �ha� under penalty of perjury ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for lhe (ollowing reason (Sec. 7031.5,
Business and Professions Code: Any city or counry which requires a permit to
construcl, alier, improve, demolish, or repair any structure, prior to its
issuance, also requires ihe applicant for such permit to file a signed statement
that he or she is licensed pursuant to the pmvisions of the Contractors
License Law (Chapter 9(commencing with Sec[ion 7000) of Division 3 of the
Business anC Protessions Code) or that he or she is exempt iherefrom and
the basis for Me alleged exemption. Any violation of Section 7031.5 by any
applicaM (or a permit subjec[5 the applicant to a civil penalty of not more than
five hundretl Oollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensa[ion, WILL DO THE WORK, and the slructure is not intended or
o((ered for sale (Sec. 7044, Business antl Professions Code: The Contractors
License Law does not apply lo an owner of property who builds or improves
thereon, and who does such vrork himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of lhe property, am EXCLUSIVELV CONTRACTING WITH
LICENSED CONTRACTORS to consiruct Ihe project (Sec. 7044, Business antl
Professbns Code: The cont2ctar5 License Law dces not apply to an owner of
property who builds or impmves thereon, and wfio contracis for such project with
a contracta(s) license pursuanl to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature Date
305]<6 (3/Ol)
Owner ID verifetl by drivers license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (rype of Oocument, i.e. - properly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cert'rfy that no excavation fve (5) or more feet in depth into wfiich a
person is required lo descend, will 6e made in connection with work authorizetl
by this pertnit, antl that no building structure, scat(dding, talsework, or demolition
or dismantling Ihereof, vnll be more Ihan Ihirty-six (36) (ee[ high. (Chap. 3.2, Gry
2, M 2, Sec. 341, Title 8, Califomia Adminisirative Code�.
❑ As owner-builder, I will not employ anyone to do vrork which vrould
require a permi[ from the Division of Industrial Satety, as notetl above, unless
such person has a pertni[ to tlo such vrork from the division.
Appliranfs SignaWre Dale
Division of Industrial Safety Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuWre building occupant need to fle antl
certity a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, with some
ezceptions, that a Business Plan be fled with the Costa Mesa Fire
Department by every business which has at any one time tluring a reportetl
year a quantity o( hazardous ma[erials equal to or greater lhan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standard �emperature and pressure).
2. Does or will the applicant or present or fu Wre building occupanl neetl to file
a registration form for awtely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Satety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of wmpressed gas at standard
temperaNre and pressure).
3. Does or will the applicant or presem or future building occupant need lo
prepare an RMPP (Risk Management and Prevention Program (or acutely
hazartlous ma[erials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Sa(ety Code provitles tha[ lhe
Costa Mesa Fire Department may require Ihe preparation, certifcation and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous materials with the Fire Department.
4. If an RMPP is presently required, has Seclion 25534 of the Califomia
Health and Safety Cotle been fully complied wi[h? ❑ Yes � No
5. Does or will the appliwnt or presenl or (uture building occupant require for
the work which is lhe subject o( [his application a permit for such construction
or modifica�ion fmm the South Coast Air Quality Management DisMct or from
any other air polWtion conUol districl or a9ency4 ❑ Ye5 ❑ No
(Section 658502 of the Calitomia Govemment Code requires that the requesletl
infortnation be fumished on applications ta noo-residential building permits).
6. Will any paA of the facility to be constructed untler this permit be within
1000 feet from the outer bountlaries of a sc�ool? ❑ Yes ❑ No
(If yes", the facility must meel the requirement o( Seclions 25534 and 42303
of the California Heallh and Safety Cotle).
7. I( a pertnit from ihe South Coast Air Quality Management District or other
air polWtion control district or agency is required for the vrork which is the
subject of this appliwtion, have all of the disclosures prescribed �y California
Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No
8. pf yes", attach certificate of compliance from the appropriate air pollWion
control offcer).
CERTIFICATE OF COMPLIANCE: I certify that untler penalty of perjury the
information given above is correcL I agree to comply with all slate laws and
city ordinances regarding Hazardous Materials and Emissions.
Signawre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
ceAify under penalty of perjury that I have read this application and state that
the information given is correcL I agree ro comply with all state lavrs and city
ordinances relating [o building construction, antl authorize representatives of
the Ciry of Costa Mesa to enter upon the above-descnbed property for
inspection purposes. I agree no� to occupy or allow occupancy of any builtling
authorized by this permit until final inspeclion.
SignaWreolLegalOwner�s) 0 te
,d�Y11 �'� Li � ! b
A�tliur.Aulh�lo rzeC'AppOmnl...� tiDate�'-
_e: ResidentiHl
Alrerationa
q �
1 oS
T
! Opaque SurfBCC D0tai15 For the turred portioned of Mass N'alis see Furring Strips Construction Tabie below. �
-A � B C T P II E� � F G H��� ��I� �T� -.1 �
'I�ag/ Assembly
ID� or Tvt
U- � 7A4 Table � CaviTy � Insulation
accouNing for Cmrlinuous /nsufotian R-value, see Pnge JA4-3 nnd Eg�mtiai 4-1. Fm'
JA4 Proposed
Assembty Assembly
;ell Values U-facror°
use
I. hor Tng/ID iirdicate 7he idenliJication name !ka! mn7ches the burlding plans'.
2. /ndicnte the Assembl>> Name or rype: Roo(/Ceiling, Wa71s, Flow�a�, Slabs, Crawl Space, Doors and e�c...lndimte �he Frame rype and Size: For
N�ood, Metal, Me�al Bn�ildings, Mass, enter 2z4, 2xG, or eic... see JA4 fw� aherpossi6le frame rype assea,bfies.
3. Emer �He ahichness for moss in inches or Syaci�g Genveen framing members emer,- 1 G"or 24 "OC,- or O�herfor a(f o�her assem6l7+ descrip�imi
such as Cnncrete Smvdwich Pane1, Spandrel Panel, Logs, StraH� Bafe Pane/ and etc....
4. Based a� !he Clin�ate Zone; enter the S�andard U fac�or fi�om Table ]51-8, C or D fm� eacla d�erent assembfp Nome m' lyye.
5. En�er the Table number tim� closelp resembles �he proposed asa�e�nbli�.
6. Eiver tlm 2-i�alue tlia� is 6eing installed in �he wa(I cm�in� or Getween d�e fi�aming; oiherwise, en�er "0 ".
7. Enler the Conlinuous h�sidaiion R-value,for' Ihe praposed asseinbl�; o(herwisq enter "0".
d'. Lnler (he rnH� and colunu� qf the U-fac�or vahie based on Co(urnn F Table Number and enler (he Asxembl�� U-facim� in Column J
). The Proposeri dssen�Giv U-facior, Column.l, musi Ge equal �o or less ihan �he Standard U-fac�or irr Column E �o compit�.
FmTing Strips Construction'I�able fm' Mass Walls Only �
A B C D C F G H I ,i K L M
Propused Yruperties uf Masonry and Cuncrete Added Intcrim' or �xterim� I�sulatiun
Walls tr�m iieference in Furring Space from Reference
Joint A�endix 7'xble -0.3.5, 4.3.(. A.3.7 .ioint A endix 9'able 4313
= o — _
U +� 1° � m �
� n� U
�- o
� Assemblp Z. � L`° F- F-� c a�,� <."v v.•.v FIDB�
Muss Nmne or JA4 7ablc a_ � e; = F rt 9 t A �_ — Assembly
u �
Thickness` T e' Number' �=` � � w° E � 3 � c 4'�` u�i C U-faCtol'L'� Commenl
I
I I
Regi.ru�uiinn Number: Regi.xn�atio�� Dule/Tin�e: NEXS Prnvider:
20U6' Residenlial Canvpliunce Forn�,r �fugus7 2009
Certificate of
P.[qject;Name:
ROOFING PRODUCTS (COOL ROOFS) §IS](p12
the nrea ojexrerior roofsnrfare !o bc replaced rxceeds inore than SO°/a
less, the ne�v roofing aren �nust n�eet rhe roofrng praduct "Cool
CF-IR-AL
�C=mate Z.one # �
exis[ing roofarea, or uiore (Gun I,OOOj�, �uhicbever is
oj§I52(bJIHi, ]52(b)1Hii, or l52(b)IHiii.
Check applicaGle a!lernntive or rxceptian beloH� if the rooja(�eration is ezemptJrom the rooJing product "Cool Roaf' requirements. No�e: /f any
one of dre a6ernatives or escepiio�� below is checked, the Aged Salar Reflecmnce and Thermal Emitmnce requiremems jor roofingproducts in
�§l 18(i) are not applicable. Do no� fill table befow.
❑ Cool Roofs Not Required in Climate Zones I-12, 14, and 16 wi[h a Low Sloped. Less or 2:12 pitch.
�ool Roofs Not Required in Climale Zones 1 through 9 and 16 with a Steep-Sloped Roofs (pi[ch greater than 2:12) and product unit weight less
Jternatives to §152(bpHi and §]52(b)Hii, Steep-slape root (pi�ch > 2:12)
O Insulation with a thertnal resistance of at least 0.85 hrft��°F/Bh� or at leas[ a 3/4 inch air-space is added to the roof deck
over an attic; or
❑ Existing ducts in Ihe attic are insutated and sealed acwrding to § 151(fl10; or
❑ In climate zones 10, 12 and 13, wi[h 1 fl''.of free ventilation area o(attic ventilation for every I50 ft of anic floor area, and
where at least 30 percent of the free ventilation azea is within 2 feet vertical distance of the roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
❑ Building has eadian[ barrier in the attic meeting [he requirements of §151(�2; or
O Building has no ducts in [he attic; or
❑ In elimate zones 10, ll, 13 and 14, R3 or greater roof deck insulation above vented attic.
Exception to §152(bpHiii, Low-slope root (pud� 51:12)
O Building has no ducts in the attic.
Other Exceptions
❑ Roofing area covered by building integrated; photovoltaic panels and solar thermal panels are
; O Roof constructions that have thermal mass over the roof inembrane wiih at least 25 IWft is ex
Note: If no
el is availa6le, this compliance meth�
box beloe� if Exem t from the Roo1
Roof Slope
Numher� <2:12 >2:Y
❑ ❑
u
�
0
❑�
u
�
0
❑�
cannot be used, use the Performance
> Produc[s "Cool RooF' Re uirement
Product Weight Product
< 516/ftZ > 516/ft2 T e�
❑ ❑
�
�
0
�❑
�
I�
�
�
from [he below Cool Roof criteria.
m the bebw Cool Roof criteria.
roach to show comoliance. o[herw��,
Aged Solar � Thermal
❑4
o"
❑9
o^
O°
The CNRC Product IU Number em� Le oblained fi'om tl�e Cool RoojRaling Counci!'s Ra�ed Produc� Direc�ory a� wwm coolrnoGcorg/pi�nducis/searcH nlm
Indicale ihe type of producl is being uaedfor d�e rooJtop, i.e. single-y!y roof, aspha6 roof, meml roof, e1c.
/flhe Aged Re/lec�ance is nor availaLle neUie Cool Roa(Ra�ing Com�cil's Rated Produc� Directory �hen use �he Ini�iol ReJlec�ance value fi�om the same
direcmp� and use U�e eqim�iw� (01+OJ(Pp������— 0.2) �o obmin a ca/cula�ed aged value. Where p is !helnitial Sa/m� 2eflecmnce.
Check Go.r iflhe Aged lielleclance ie� n cale�Ja�ed nolve using Ihe eguolion nGove. , �
Calcufom !he SIU value Lr using Ihe SRl- N'orksheel a! hJr/Av�vin enerp� ca env/liile24/ ond emer Ihe resulling value in �he SR/ Co(umn obove ond ottuclr uco/iv
�de SRI- IVor•ksHee! in !he CF12.
� apply Liquid Rield Applied Cuatings, Ihe coating must be applied across the en[ire roof surface and meet the dry mil thickness or coverage
commended by Ihe coatings manufachirer and meet minimum performance requirements listed in § 118(i)4. Select the applicable coating:
Aluminum-PigmentedAsphalt RoofCoating
Cement-Based Roof Coating
Other
Regisn•ution NumGer: Registra�ion Date/Time: HLILS P�rovider:
2008 Residentia/ Campliance Forms� �
August 2009
,. f , . .
i r���
CertiSicate of
2esitlentirtl Allernti�m,c
Yryq�Uynme: ��1�-1-/qd
ce: Residential
�
CF-IR-ALT
(Pa;�e 5 01� 51
I-Ill',ILS ��Li'RIF]CAT1011' SUMBQAS'�)' The enforcemeni agei�cr shoiild pm� syema] cilierwmv ta ll�c HERS 6feasw�es a��ecif�ec! in tl�ia
checldist belom. A conepl eied iind s'io��ed CF-4If Fmvn for nll the men.t�ure.r specified shcJl be suLmifleU ro iht+ building ir�s7>eelor bejm'c- �i��cd
DuCt Sealille & iCStille HG2S verificniion is renzrired Jm' Ihi.t mens'ure.
❑ �'ES ❑ NO 1'ES:In Climate Zones 9 and 9-l6, if mort tlia�� 40 linear feei of ne��• or repl�cemeni dueLe are insialled in uncondiiioned
� space, the ducts ure to be seuled per §152(b)IDii and the new{y ins�alled ducts are ro be insWated pe� §]51(]"110.
❑�XC�PT10�: Lzistine duci syslems that are extended, whicL :ve cuustruc�ed, insulated or sealed �vith asbestus.
❑ Y�S ❑ NO 1'i5: ]n Climate `Lones 2 and 9-16, if the existinE space-conditioning system (HVAC equipment and ducungl is replaced, the
� ducts are to 6e sealed per §152(b)7Di. �
� 1'$S ❑ NO 1'�5: ln Climate Zones � and 9J G, if Uie existin� HVAC equipmem is repluced (including the replacemem o1 the air I�andler:
' outdoor condensing unii of a spW system, cooling or heating coil, or the fiirnace heai exchaneer) the ducts are to be
. sealedper§152(b)]E.
❑�XC�PT70N: Duci systems that are ducumented to have been previuusir sealed eonfirmed tliruugli H�RS
- veriticztion iu rccurdance vvith procedures in the Reference Residentiul Appentliz RA3.
� - ❑�XCP�PT10�: Duet systems with Iess than 4U Iinear teet in unconditiuned spuce.� - .
❑ EXC�PT10�: �xistin� duct svstems conatructed, insulated or sealed �vith asbestos.
Refriperant Charee - Split System HERS veri/ication is required.Ia� �his n>ea.nve.
❑ 1'�S ❑ NO YES: In Climare Zones 2 and 5-15, when the existing HVAC equipmen� is repiaced (including the replacemen� of the air
haodler, outdoor condensing unit of a split system A/C or lieat pump, cooling or heating coil; or the fumace heat
exr.haneeri a refrieerant charee meesurement shall be verified per §152(6pF.
Central Fan Integrated (CFI) Ventilation S,ystem and Fan �'att Draw�
The ventilation reauirements of F150(ol do not anolv tn existinc residential homes.
Ducted Split Systems - Air Conditioners and $eat Pumps: AirfloN� HERS,�erilicaria, is required for this measure.
❑ Y�5 ❑ NO YES: ln Climate Zones 10 through I5, wlien the existing space-conditioning system (HVAC equipment and ducting) is
replaced. the airtloe� and ian watt draw shall be veri5ed ner § 1;2(6)1 Ci to meet the renuirements of & 1�l (f�7B.
• I
Statement
CJ
g7"�'3�
qz�u�
�rxte and
Signature:
Dare: rj /� // �
v� � �
]f Applicable � CEN m
��u d�r�-����
ResponsiUle 73ui)dine Designer's Declarati��i; Statemen7 �
e=1•am eligible under Divisinn 3 of thc Culiforniu Business uncl Professions Code to accept responsibility for the buildi��g desi@n identified on
this Cenificate of Compliance.
• ] cerliiy Ihai thc energy fea�w�es uncl performance specification;, for the buildin� desi�n identiLed on this CeniLctue of Compliuncc conform
tu the rcquiremenis ofTitle 24, P�ir�s I and G of the Californiti Code of Hegulations.
• The building design fentw�es idemi(icd on t6i� Certificate nf Compliance nrc consisiem wilb (hc inl6rm�liun prnwded to dueumeni Ihi.s
buildin� design on lhc other �ipplicnble compliance forma-, wnrLshceis, calculatimis, pluns aud speci�Lcatiunti submltied tn the cniorcemem
ueener foi �PProvul with tliis buildinp penni� app6cation.
N�une
CompanY:
Signature.
Uate:
Phmie:
Tnr «,s.si.rinnce nr qucetinns regart(in� qic Lnergi' Sumdtu�tl.s. cnn[acl tlic Lneror Hotlinr at: 1-b'00-7i2-;300.
7�egi>v+zuinn 7JuniGer'� Reg�.rrrmion Laic/Tin�e: 1-/Il'RS' Pronicier:
20pf; ]tasidmivial Con�pha�ce Forms fiz�gir.ti�� 200J
C6sta Mesa Building DeparLment
y' �-� 111 EAST 20th STREET
COSTA MESA, CALIFORNIA
�OR APPLICANT TO � LL IN
Building�/� �� i�
Address J C.���
Costa Mesa, Califorrua
Nearest
Cross SS.
Owner b{ 1y C '
Metes and
M
from
.
Lic.
/ City Lic.
e No.
�� a� '
c� I 7ract'� �
of
'-v
No. of /
R�
[CATION FaTB PEIt T `"'-`-""
BUILD,�NG '�
r var �
; --
Date F
a - 7-
E ONLY
__ �Permit No. �
-�i 3 5� � �
Date Issued '
�-��{-S b
�
Costa Mesa, California
Nearest
Crow St.
Zone ../ I No.of I Tvoe i I
� �% V� . I � '� "�.'v
p,'�N-�rc?\1, !,a„�I'
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Buildin9 �da � � No. of / / CCitl
Size Rooms Stories
terior Wall '� I Roof
vering Coverfng APp��7,��'
Vse ot New + ,
Building Foundation Loeatfon Inspectoi
. ` Forms, Materials,
r� � Under-Pinning
� Frame: Fire Stops, �
Bracing, Bolts
I.hereby acknowledge ihat I have read this Application Lath. Int.
and state that the above is correct and agree to comply Lath. Ext.
with all Clty Ordinances and State Laws regulating
building construction.
Sfgnatureof 1 � Plaster, Int.
Permittee
Plaster, Ext.
AuShorized Agt.
Masonry Reinforoed
Valwation � PermitFee $ / (o i0
Plan Check $ O eond Beam
$ S� ���.� Total
Fee $ � %f, � � FINAL
'FONM 204 G-N 2M 5-54
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= l,,�osta Mesa Bui ding Department �
� 771 EA&T 20fh STREET cji�
+ � � COSTA MESA, CALIFORNIA ���
FOR APPLICANT TO FILL IN I
Building � f� ✓
Address .�Yi
Costa Mesa, California
Nearest /µ� _
Cross St.
Owner '
Mail I
Address .� f _
or
(Attach Metes and
-�
Size of Lot �v j_
Use of �
Existing Bldg. (/G�
Setback Line irom
Bullding
�J
Alteration
Movfng
No. �
� Roo�
�C'i� �
APPLICATION FOR PERMIT
BUILD NG '
�d�'OR OFFICE iTSE ONLY
_ _ Receipt,No. _Permit N�
� 3 -'S�
;etved by, Date Rec'd. Date Issw
� a -7- S 6 � ��_
ing
ss
Costa Mesa, California
Lic. . I � i� � Plans , �� l� �
No. �, Approved�
' b Date
�Y �.�. CORREC�'IONS
No.
J
� Addition
IDemolisF
3 Stories
.0 -- n:
. ' �. .
APPROVALS
iundation Loeatfon InspeCto
Forms, Materials,
Under-Pinning
�ame: Fire Stops,
I hereby acknowledge that I have read this Application `"`�. ��`.
and state that the above is correct and agree to comply Lath. Ext.
with all City Ordinances and State L.aws regulating
building constructio
Signatureof �� , P�aster, Int
Permittee `� s
Plaster, E�
Authorized Agt.
Masonry Ri
Valuation ' Permit Fee $ /
(� q Plan Check $ �� D J Bond Beam
$ / � / 2 � Total
J Fee $ � �� � v FINAL
FONM 204 G-H 2M 5-54
Date
I�■
� � �����
!A MESA BUILDING•SAFETY DEPARTMENT
/P. O. BOX 3f7 COBTA MEBA. CALIFO6NIA
' For Applicanf fo Fill In Compleiely
� TYPE R PRINT �/�_
BUILDING _�%/2 ^ '//�C�'tT�/�� .'/' 1 �
ADDRESS T •L� X��
COSTA MESA CALIFORNIA
■ MAIL
■ SIZE
TEL.
LINE FROM
TEL.
NO. OP 8LDG8.
N'OW ON LOT
DESCRIPTION OF WORK
EXTERIOR WALL ROOF
COVERIN6 COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
5
� � _ • �
FEE RECEIVkD
FEB 9 1961
��FINANCE DEPt.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Offite Use Only
RECEIPT NO. PZRMIT�:i
�3���
BY I DATE FECEIVEO � �ATE�183UEO
COSTA MESA.
FIRE
ZONE
APPROVED
ZONING
��� I PLANS � I BUILDING E
LEGAL � �/�y I
U88CRIPTION L� • J
A. P. N O. ��� I �� C
YAR�S EVES
APPROVED ALLOWED
(CENTER LIN¢ eTJ .
APPROVED
I HEHEBY ACKNOWL6UpE TXAT 1 HAVE PEAD THI9 APPLIGT�ON THE AMOUNT 6HOWN UNDER VALUAT�ON I6 POR THE
AND 9TAT8 TH�T THE A9GVE I8 COHRECT AN� AGREE TO COM-
PURP08E OF EBTABLI9HING � PERMIT FEE ONLY.
PLY WITH I1LL GITY OFDINANCEB RND eTA W9 R8011LATING
Bu1tDiNa coxeinu VALUATION
SIGNATURE OF � j�� � PERMIT FEE $ .� r
PERMITTE
$ PLAN CHEGK $ �
AU7HORIZE� A . �
TOTAL FEE y�
Costa Mesa Building De�artment AI'PLICATION FOR PERMIT
.. � � P.O.Box3�� �.;30� BUiLDING '
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
Receipt No. Permit No.
Buildfng ��2L:.�. n� ' �j'�
Address �/ ,J
Costa Mesa, California Received by Date Rec'd. Date Issued
Nearest % — 3 —S �O 7— 3 �S
Cross St. Building .
Address
Owner '
' Costa Mesa, California
Mail ' ,r �
Address �_I � `�%�yµ,�.L-.� .1J° Nearest
Tel. p Cross St.
City �Ad��.4,w.-� No..� e�i��c3 1 Zone .. . I No. of I Tvpe ,/ Group
Address
Legal I Lot
Description No.
(Attach_ Metes�
Size of Lot_.Ji��
Center of
r
ng
lor Wall
.,�
7 I Block
M
City Lic.
No.
Tract
Now on Lot
No.of � No.ot
F�amilies Rooms
RearYard . _
Demolish
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply
with all City Ordinances and State La egulating
building constructi n
Signatureof � Q1
Permittee
Authorized Agt.
PL
Forms, Materials,
Under-Pinning
�ame: Fire Stops,
I nt
Ext.
Valuatlon Permit.Fee $ u� Masonry Re
$ �JJ � Plan Check $ " Bond Beam
v � Total
Fee $ � I FINAL
RM 209 10�55 D. P. S 5.
Mesa
fe
tl
Costa Mesa Bnilding Department �
� ' P. O. Box 3!7 �
COSTA MESA, CALIFORNIA a3_
FOR APPLICANT TO k',.ILpL— —IN—
di�g � �..z �X�'""` ' YI
ress
Costa, Mesa, California
rest Lf - _ '- � ^ �
neer
(Attach Metes and B�
Size of LotV � X
Use of _ .
New I" I A
Repair I I M
Building
ae
erior Wall
APPLICATION FOR PERMIT
BUiLDIN;G '
FOR OFFICE USE ONLY
rr-"�Receipt No�..J Permft No.
�� � 3 / S o
:eived by � 'Date Rec'd. Date Issued
�vnl G-L�_;�I �-�-.
Building
Address
� Nearest
Tel. Cross St.
rvo.�zY'�to'q Zoney?
Lic. � �"
No. Approve
�cy
'> ��.7 / 7f/ �03.
INo. of Bidga ��
Now on Lot
INo.of I No.of /
Families Rooma«
i Rear Vard h �
Roof
Demolish
c
�
CORRECTIONS
Buildin ('.�� �/ Foundation Location
Forms, Materials,
� Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Int.
with all City Ordinances and State Laws regulating
building construction. � Lath. Ext.
Signature oT �
Permtttee Plaster, Int.
Authorized Agt. plaster, Ext.
Valuation Permit Fee $ �'�� Masonry Reinforced
$ ��/ Plan Check $ '� Bond Beam
� Total
Fee $ � FINAL
Rm zoa lo�sg o, p, n s.
Inspector
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PLOT PLAN �
Show loeation and tlistances trom � �
properly Ilne and between 6uildinga �
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