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Home My WebLink About1045 MISSION DR - Building PermitsJob Address: 1045 MISSION DR Status: ISSUED Suite: Applied: 09/09/2005 Vicinity: Issued: 09/09/2005 Primary Occ: R3 Type of Construction: V -N Parcel Number: 14166401 Zoning: Applicant: JERRY BLAMKS Address: 17501 NORWOOD PARK PL Phone: (714) 573-0155 ISSUED BY: Arch :-''�` TUSTIN, CA Zip: 92780 Address.__-_ Owner: DILLOW, BARRETT C TR Phone - b..0 , °s Phone:" d'e• Address 17220 NEWHOPE #224' r License 3a : Licensei a TEAR OFF SHAKE INSTYALL 7116'.OSB 1 ' SCOPE OF PERMIT' LAYER 30LB FELT UNDER 30 YR COMP. SHINGLES' . -'s- Phone FOUNTAIN VALLEY CA a Zip 92708-4288 Plan Check - $0:09, -. �� CalcValuation $11 400:00 Permit: Contractor: PREMIER ROOFING AND BUILDING CO,INC Claim Valuation $11,400:00 SMIP Res $1.14 LV,r� fes. ;SMIP Com ` Address PARK PL.: �"" 175011 NORWOOD4, •-- "` $0.00 - 1 ., t Phone (714) 573-0155 , -`- ,- TUSTIN, CA>1 P-"�• to -`� Zip ' 92780 °•' License: 634404 ' Arch :-''�` - Eng: Address.__-_ Address: Phone - b..0 , °s Phone:" d'e• t y Ai ' Zip License 3a : Licensei a TEAR OFF SHAKE INSTYALL 7116'.OSB 1 ' SCOPE OF PERMIT' LAYER 30LB FELT UNDER 30 YR COMP. SHINGLES' ' FEE SUMMARY Plan Check - $0:09, -. �� CalcValuation $11 400:00 Permit: ,$206.26,`" Claim Valuation $11,400:00 SMIP Res $1.14 LV,r� fes. ;SMIP Com 3 ; $0 00 v4AW,e r Other $0.00 'inspection,$0.00 to •Total. $210.39 1. PLANNING & ZONING SETBACKS MAIN STRUCTURE €"" Front 0 0,,. Rear 0-'0 Left 3 0-0 Right ' 0-0 . � by n s � ._ ACCESSORY a� Front 0-0 Rear 0 04 ,,Left '°'0 0 ,I` �, Right 0-0, PARKING Existing 0T , Required �;,,0,,,,Proposed:, If;41 ��- 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, 12-21-92) 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 authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. "''+1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. `My workers' corn 9''0 In nce came nd polity number are: j7 � _ ` �% L / Policy Num 1, {� Cartier. i lr/V Polity Number: / ✓ �� (This section need not be completed it the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the pedornan a of the work for which 's permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o1 Calif, ia, and t if I uId become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shell forthwith comply with these provis' 1s. Applicant Sig ure: D�flte_�S 1 WARNING: FAILURE TO SE E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENAL ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLM (51 ), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provlslon� o h pier 9 (commencing with Section 7000) of Division 3 of the Busines-{ and Pro sions Code, and my license is in full farce and effect: UC kr / Class ♦ C 3 Contractors. Date: 4 tContractor CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work 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 owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 6, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one lime during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .........................................-.....................................................................................................................................................................................................................................................................................I....................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety 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 compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management antl Prevention Program for acutely hazardous materiels)? ❑ Yes ❑ No (Sectlon 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. d If an RMPP Is presently required, has Section 25534 o.. the California Health end Safety Code been fulty complied with? ❑ Yes ❑.No 5 Does or willapplicant present or future building occupant require for the work which is she subject of this application aPermil for such construction Or modification from the Southth Coast Air Quality ality Management District or from any other air pollution control district or agency? Ll Yes LI No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ......_........._........_........__........._..............__.......___......................................_..._._.............................................................................................................................................................................................................................................. 6 Will any part of the faciliy to ba constructed under this permit be within 1000 feet from the outer boundaries of a schcol? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). _......_......_......._. ...... _....... __............... _........ __.............................. __..........................................................._........._......... ................_.._......._........................ _.................. ........................................................................................ 7 Ii a permit from the South Coast Air Quell N Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ...__.._......_........_......ch certificate co_.plian..........................__...__....................................................................r)....................................._........................................................................................................................................... 8 (If yes", attach cortificate of compliance from the appropriate elr pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SI natur r(s is And( r'Authodied Applicant- CODE 1, INSPECT]dirrym INTITIALS CODE# INSPECTION TYPE gm INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Rcof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildingfOccupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ccaUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1045 MISSION DR Eng: Address:, "-"�� Status: ISSUED Suite: SETBACKS, Applied: 12/10/2002 Vicinity: ROOF ROOF. INSTALL -.P Issued: 12/10/2002 Parcel Number: 14166401 Zoning: ._ .. _ ._ Applicant: DAVENMANITRIPATHI ISSUED BY: Address: PO BOX 6569 C `- Right 0- 6'111 FEE SUMMARY,,/"/ Phone: 714-997-5684 - Plan Check ORANGE, CA - - Zip: 92863 , = --Calc Valuation: y, Owner: DILLOW,,BARRETT C TR Address %17220 NEWHOPE #224' - - - i Phone: /;FOUNTAIN�VALLEY CA - Zip: 92708-4288 Contractor: ROOFCOO RP OF CA INC DBA HOMES ROOFING , Address, PO BOXi,O65 9' Phone: -714-997-56f ORANGE, CA Zip: 92863 License:" 803718 Arch':' Address: `Zip: "-S -Phone: - - -License: Eng: Address:, "-"�� Phone: <" ` 'License: SETBACKS, SCOPE OF -PERMIT - TEAR OFF EXISTING ROOF. INSTALL -.P 29 Y€AR COAAPOSITIOALSHING� F¢sx:F,�{- REPLACE DAMAGED SHEATHING. ` 1, 100 S.F. FOR � ONLY. --` _- -- ._ .. _ ._ ,- ._ ., _ 0 Ror 7 .. C `- Right 0- 6'111 FEE SUMMARY,,/"/ " Plan Check $0.00 - __ _; �� = --Calc Valuation: y, $1;689.00' Permit: $60.10 ,, - yr Claim Valuation: / .; $1,689.00 SMIP Res: $0.50 / _ SMlp Com: $0.00 Other $0.00 `Inspection. 'y$0.00 Total: $60.60 -\ 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, 12-21-92) 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 authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244648 (6100) PLANNING & ZONING:: SETBACKS, MAIN STRUCTURE Front 0-0 Rear 0-0- Left 0-0 Right 0-0- ' ACCESSORY Front 'b-0 - Rear 0-0 Left 0= 0 `- Right 0- 6'111 PARKING Existing: 'o, Required: o Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) 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 authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244648 (6100) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ®� I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. T My workers' compensation Insurance car at and number are: /� q Carrier:, p l 64.. �4MSn, I1Yz1v-L � Pol`cy Number: O% Q y t(fi/s section need not be comple i/ the permit Is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this pemlit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. ,Applicant Signature: d�,(/�J_�'�-� ,Oate.:— WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37D6OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full .force and effect. Lic.#_-- ��'��/R 422w #i--- 39 Contractor's Signature: Date:— CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) it that he or she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work 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 owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection With work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, 1 will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 WIII the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ..................__......._.................._..........._.........._.......__..........................__.—_..._............................................................................................__......................................................... Ye's ............. ..................................................... 2 Does or will the applicant or present or future building occupant need to file a registration fore for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety 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 compressed gas at standard temperature and pressure). ............................................. _....... _.......... _.............. ............... _......................................................... _.._................................................................................. _......................... __........................ ... ................. _.......... _......................................... 3 Does or will theappplicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes 13No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .............................................................................._.....................................................................-............................................................................................................................... ............................................................................................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No 5 Does or will the applicant orpresent or future building occupant require for the work which Is the subject this a plication appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? )? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building pernits). ........._. Will ................_..........._...........__..........................................._.....-.-..._.................. f'e"..t"I'r....................................n'd,.........s"'o-...............Goti.......................................................................................................... 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer bountlaries of a SUool7 ❑ YBS ❑ No (it yes", me facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..............._.................._............................................................_.........................................................._......................................................................_...._-............................._............................................_......................__.........._..................... 7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the wont which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Cade Section 42303 been made? ❑ Yes ❑ No _................ ..-... .................... _....... ..._....................................... _.. B (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify, that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date b' 4 And/OfAuthorized Applicant `Date:. CODE t. INSPECTION TYPE ge,� IUff-MALS CODE! INSPECTION TYPE jfajE INTITALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof �•— - c73 210 Final Electrical 201 Final Slock/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 From the Desk of ..... , BUILDING DEPARTMENT n City of Costa Mesa Building Safety Department C'E R T I F I C A T E OF OCCUPANCY N° 1978 C. P. O. Box 317 Costa Mesa, California The Building located at 1045 MaSiM WIVes As D. C ® A has been inspected and found to comply with the provisions of all City of Costa Mesa,Ordinances applicable thereto for a Group 11 J Occupancy. Use of Building" Legal Description lot (See reverse side for Metes and Bounds) Building Permit No. Electrical Permit No. 29%n Plumbing Permit No._ '+`+ Floor Load Signs have been installed as required under Sec. 2308 U. B. C. Room Capacity Signs have been instaled as required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency, (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The ,number of apartments or guest rooms. , 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article S. Number of apartments— and/or guest rooms ISSUED TO: Building Official DVAM .. .. - Date is This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Farm su34—trd-11-63--S-B r u City of Costa Mesa �� Building Safety Department CERTIFICATE OF OCCUPANCY NO P. O. Box 317 r Costa Mesa, California ' The Building located at U45 Wool= I: Veo ej ,8i C D " has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 1 %T Occupancy. Use of Building tIbUr'ez Reach= V'thattedhed Garao_— Legal Description�� - t (See reverse side far Metes and Bounds) homh Building Permit No. Electrical Permit No. Plumbing Permit No.! Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms ' 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required' under Sec. '17050.1 (d), California Administrative Code, Title 8, Chapter 4, Article B. Number of apartments and/or guest rooms Mai ISSUED TO: Building Official /f r Date— aw 1s 19&• This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Forrn BU34-1M-11-63—S-B P 413 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING /C,�f..t'iron/ .DA , I ADDRESS MAIL ADDRESS� 112-/�IQf �a-�r/s�� LV �a CITY AP 4j jOA9 %si�%!4 LENDER LENDER BRANCH ADDRESS ARCHITECT %2` n _ iii f ti.) NO` OR ENGINEER 1l)r `- Vr r-W.�L ADDRESS J CONTRACTOftttl6w) 0/6 ADDRESS TEL. CITY NO. STATE �, CITY LIC. NO. LIC. NO. SIZE NO. OF BLDGSOF BLDGS. OF LOT NOW ON LOT OSE OF EXISTING BLDG. Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED PAIR // UP z 7E�, N LIl)A00 570* *****5.50 AP TIpN FOR STRUCTURAL PERMIT RE�77ffa DATE RECEIVED D E E r A.P. NO.'4) _ 1(Ili` SQ. FT. THE AMOUNT SHOWN UNDER VALUA THE PURPOSE OF ESTABLISHING A PERMf VALUATION $ / BUILDING'D�T ADDRESS �)I �,t . t. `) Authorized Agent /J "J e /� TRACT. .V. LOT. BLOCK W A LTER REPAIR OWNER Ilf o' 2i ICL t' a c'C.mc�1 uv IE us FIRE ZONE TYPE GROUP APPR V RY DATE ' ZT L/ IUSE OF NEW PLANS �I BUILDING �YAROS APPROVED .YAF.DS APPROVED ;APPROVED .YAF.DS APPROVED ; VAR. * BET. MAIN & ACCESS. BLOGS. DATE APPROVED I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California.' I hereby certify that I am properly licensed as a contractor under the Stare of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I am exempt from the provisions of the State of California Business and Professions C Division 3, Chapter Signature of Permittee Jr� SQ. FT. THE AMOUNT SHOWN UNDER VALUA THE PURPOSE OF ESTABLISHING A PERMf VALUATION $ / PERMIT FEE $ PLAN CHECK S TAX $ Authorized Agent TOTAL PAID $ OWNER DILLMAN-BRJHd= ENTERPRISES DATE MAR 1 -, 1963 JOB ADDRESS 1045 Mission nr• A thnl D BUILDING PERMIT NO. 19pO2 GENERAL CONTRACTOR nillrOnn-Rr11mmP11 EnterlY'jSQS VALUE $ 45,610.00 AP No. LOT 34;1 TRACT 22 FIRE ZONE DESCRIPTION OF WORK4-plea W/att.ga INSPECTIONS I Signature) DATE GROUP HR.T TYPE V ZONE R-4 SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Water Rough Conn. Refrig. ❑ Air Cond. ❑ Rough Heating Rough Plumbing�: - _ Miscellaneous Prop. Swr. Line ❑ Ho e Con. ❑ St. Swr. ❑ QCI--9_I, 6 _ _ _ Sprinkling System ,..yc,..v- ji/ t — — Constructio-nPo e Underground wPower Vgh Wiring ' rent es L korms17tee em . _ c� L,L_ 1_ Floor System me 63 Bond Beam ❑ Steel Reinforce ❑ Sheathing. - Frame and Flashin $ _ 8: • ��^ Lathing — In OutG Plaster, brown coat @- ✓ / Refrte. ❑ Alt Cond. ❑ Final He �, Final j-'iv-uf _ Flu.. -Ing Fixtures, Final _ l• )— Final Gas Test _ - Electric Fixtures, Final Building, Final OCCUPANCY FORM B04 - 5M — 7-61 1 on(y) 'COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA'MBSA, CALIFORNIA ' For Applicant to Fill In Completely TYPE OR PRINT _...._..._ 4 Mission rive,/ COSTA MESA, CALIFORNIA CITY Garden Grove N`O`.'S30-11E ARCHITECT ORENGINEER Walters & Son No OR 3-67 -Ess 436 Heliotrope, Corona del Mar RACTOR Self - ADDRESS CITY STATE TEL. LIC. NO. NO. -- IZE LOT •801XI%3I OWON LOT 0I'_9F �6-IY.Ia ?Tm 40C 1 CI11 REAR YARD_5' EFT 5 1 RIGH a, DESCRIPTION OF WORK X. II ALTERATION I II ADDITION SRE .'IR •441X %. T200M8 Z8 STORIES2 EXTERIOR N3LL Stucco I ROOP_ - - Shake 1HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOV B CORRE Y O AGREE TO COM- PLY WITH ALL CITT ORD T 8 a. REGULATING. BUILDING CONSTRUCTI RECEIVEX BY ti— SIGNATURE OP DATE 193U¢D MAR 1 ? 19E F AUTHORIZED AGENT I F E RECEIVED MAA` s FINANCE DE�. A PLICATION 'FOR'PERMIIE . BUILDING For Office Use Only 3 RECEIPT NO. T.4hno RECEIVEX BY ti— DA 8 RHS IVED �63 DATE 193U¢D MAR 1 ? 19E BUILDING ADDRESS 0 FIRE )� �G ZONE TYPE P GROUP / 0 APPROVED BY DATE ZONING ZON `I r FLA OP LAN.S/�, USE OF NEW BWL-DII.N. LSGAL DESCRIPTION q A. P. NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN SOITO SIDE a REAR P. L. EAVES ALLOWED (U.B.C.REQUIREMENT) YARDSAPPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING (FROMC LST ETI FRONT PT. FT, ^� R. SIDE LFT. FT. L. SIDE FT. P FT, / REAR l FT. FT. DISTANCE BET. MAIN SLOGS. BET. MAIN R ACCESS. BLDGS. VAR.# C. U. P. # DATE APPROVED APPROV BY DATE �� THE AMOUNT SHOWN UNDER VALUATION 19 FOR THE PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. F VALUATION SPLAN /?' _ PERMIT FEE SZ901 J G CHECK.7�/ TOTAL FEES S 3