HomeMy WebLinkAbout208 AMHERST PL - Building Permits 4` 9 CITY OF COSTA MESA
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BUILDING DIVISION
> • "1.144..,��. DEVELOPMENT SERVICES DEPARTMENT //PERM
�. • _•••••••1 . PERMIT
" „o ,a*' P02-00745
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 208 AMHERST PL Status: ISSUED
Suite No Applied: 12/18/2002
Issued: 12/18/2002
Vicinity: /e
Parcel Nunmber: 14146504 ISSUED BY: `/ (�'�
Applicant: JOHN MELROSE
Address: 1525 MACARTHUR BL.
Phone: (714)641-1545
COSTA MESA,CA Zip: 92626
Owner: CONWAY, GWEN R TR
Address 208 AMHERST PL
Phone:
COSTA MESA,CA Zip: 92626
Contractor: C AND R DRAINS INCORPORAT
•
Address: 1525 MACARTHUR BL.
Phone: (714)641-1545
COSTA MESA,CA Zip: 92626
License: 531746
Arch / Eng: -
Address: .
Phone:
Zip:
License:
SCOPE OF PERMIT
INSTALL WATER HEATER.
•
• FEESUMMARY -
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 • -• Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Bdcr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 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
2446-46(6/00)
DECLARATIONS n • (tel
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I 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.
rs'compensation Insurance carrier and policy number are: _
rrier: 54 f/‘11 /_.-r4077 /¢ 7 'ci'#*' Cr- c''''? "•icy umber: C 7 -SOC Cob
(This . n ne not completed if the ermit Is valued at one hundred dollars($100)or less.)
❑ I certi that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
pensabo s of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
co Ith rhes pr ions. ,y, )per'
A Icant Signature:S �`s %/J/�-/�/ili✓L Date: /2 //)
W TO URE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMP CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE( W,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION: '
I here Arm that I m licensed under revisions of,Chapter 9(commencing with Section 7000)of Division 3-orte ''Business and Professns Code,and my license is in full
1 e and effec Lie.atu e: 6 .- N /' b
CONSTRUCTION LENDING AGENCY:
❑ I 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: Lender's 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 properly 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. 0 Yes 0 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:
9 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, 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? 0 Yes 0 No
(Section 25505 of the Califomia 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).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 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 and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the Califomia 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? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application 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 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 facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes D No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code).
7 If a permit from the South Coast Air Duality 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 Califomia Health and Safety Code Section 42303 been made? 0 Yes ❑No
8 (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.
GTflign 01 Le wner(s)
GZiii Date
And/O�Auth ' ed App'cant , Cate
CODE t INSPECTION TYPE DATE INTRlALS ;ODE* INSPECTION TYPE12/1.1:EINTDIAL$ .41616 Fixed System Final Fire Prevention 206 Final Mechanical _
1266 Pool Spa Final 208 Final Plumbing I It, / —Oa pl`L
200 Final Re-Roof 210 Final Electrical
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
NECTADDRESS:
208 AMHERST PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 065985
NEWS NAME: CONWAY GWEN R TR
• ADDRESS: 208 AMHERST PL PERMIT NO: B 065985 PLAN CHECK NO: N GOVT: N SUPP ; N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; T/O & REROOF W/COMP , SHINGLES
ADDRESS: UNIT: SQ FT: 4 , 000
CLAIM VALUE: 4 , 000 . 00 CALC—VALUE : 4, 000 . 00 GROUP OCC : R-3 /
PERMITTEE: DAVID ALBERS ( 714 ) 839-8904
ADDRESS: 1010 ELLIOT PL COMMENTS: SMOKE ARE REQUIRED IN EVERY BEDROOM & HALLWAY, U. B .C. 1991
C.M CA 92704 ****+t**x************************+6*****1k*****************16*********** *ar********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G R E Q U I R E M E N T S
7000)of Division 3 of the Business and Professions Code.an icense is in lull force and effect.
CITY LIC.:�'T STATE LIC.:65765 CLASS: B' S E T B A C K S
ale'�/ .2'—(1'4y Signature: `^• t �r— I LAI MAIN BUILDING ACCESSORY BUILDING
ERS'COMPENSATION DECLARATION: I hereby affirm that I have a cenifitatebt onsent tos insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT : FT IN REAR; FT IN
Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
, COMPANY: PARKING REQ: PROV: PARCEL : 14146504 ZNE: REF NO:
Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING N TES> ,
> •
Date: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). D E V E L 0 P M E N T S E R V I C E S REQU IR EMEN TS
I ubir that in the performances'Compensation of the work for which this p issued. sh;ll n mployrl mariner so as to become
sable the Workers'Compensali°nLaws olCalifornia. e(i Isi /L/�/ ZONING APPROVED BY29 DATE:
, F.tg Signature:
4 '/TICE:If,after making this declaration,you should bec e subject totttbe Workers' Compensation provisions of the Labor BUILDING APPROVED BY DATE:
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: iff
DATE: GIS
which this permit is issued(Rection 3097,Civ.Cl. **M.*.**{E*.IE.IE.lf.1(.{t***.N.***.1E.N..IE*.iE#**.*.**.x.*.x,.kif,*****,*******,%***,N,****x,********** * ***** .
LENDER: **********************************************************************. ********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
'OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law far the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 63 . 00
repair any structure.prior to its issuance,also requires the applicant far such permit to file a signed statement that he/she is licensed5 0
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 63 . 50 '0 . 00 0 . 00 63 . 50 63 . 50 • 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED TED • 5 OVER/SHORT• 0 0
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ,(���
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRS MIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 6 3 . 0 0 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).l am aware *******************-*.***-*.********.**..1e******.*.*.*-06*.*.*.4E***.***.*.**.N..)f.***.**.NlE************
that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L F E E BREAKDOWN
❑ I am exempt under Section: B.Si P.C.
for this reason TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 4 , 000 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for these provisions.
construction or modification from the Air Duality Management District.Residential construction applications are exempt from
Date: Applicant: SMOKE DETECTOR
Dal
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county REQUIRE()
ordinances and state laws relating to building construction and e y a orize representatly Ithis city to enter upon the aboveimentionetl
: ,.edy for inspection purposes.p � l
Dal: ^�'� / Ci Signature: �•/�iJ L�/re! Alva/ 01 00155153-00155154 TOT 63.50
:river's License or Social Security it: DATE: 02/09/94 TINE: 08:45 I
1.0
1641-46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
11 _ I
< CONSTRUCTION AND PLANNING POC- SPA
APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnci. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap • 63. Heater & Vent-Final
13. Roof Drainsr
64. Plumbing System - Final
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit
21. Ducts, in Structure 70, Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 2,to- if 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT :
31. Plaster Brown Coat 79. FINAL INSPECTION • v4'
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 10-11-11/ l¢t
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
•
s �
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION 625`i
// n T /� Permit No. B 9
Property Address �6 A m1/Y e iQc l f'� C
Owner l -Q4—�1�.( 0Z1 {. �)
Contractor k /t'�kip 0 0/Pm
State Contractor License Number 0 5) 6 S 2 Classification r3
I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the
above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building
Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the
manufacturer.
❑ I further certify that I am the owner of the property. (Owner-Builder permittee only).
El- I further certify that I am:
'E Owner of sole proprietorship company
❑ Full partner of the company
❑ Limited partner of the company
❑ Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered to make
this certification, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building
Division for acceptance.
DDAA j ML aic
/ Company or Corporate Name
% D1D ELL1Kt pc.
Address /�
Received by Buil.'„ r'"isr c A ek) /� �y'1
B • i lL ) aQQA.0ti4 fe J3j
Signature Date
fn z i�j r( J� C .-P R S
nitial Date Printed or typed name
0990-46 White-Building Div.;Canary-Contractor;Pink-Owner
`opF •TY OF COSTA MES
4 CALIFORNIA 92626-1200 PO BOX 1200
„r45-
,2
4 I
g; DEVELOPMENT SERVICES DEPARTMENT
(7471
F4 4
September 19, 1994
Dear Costa Mesa Property Owner:
In reviewing past permits, we find that work has been done on your
property located at 208 Amherst Place, Permit No. B65985, for a
roofing permit. The permit is valid for 180 days from issuance or
your last inspection, per Section 303 (d) of the 1991 Uniform
Building Code. Should we not hear from you within 10 days, your
permit will expire as stated herein and additional fees will be
required to finalize the permit. Failure to final a Building
Permit could possibly impact the future sale of your property.
To activate the above permit, please follow these steps:
1. Telephone (714) 754-5626 or 754-5627.
2. Request an inspection; state address, permit number, and type
of inspection.
3 . Be sure to have working smoke detector's as required per
Section 1210 (a) of the 1991 Uniform Building Code.
4. Have an adult present at the property at the time of
inspection to provide us access.
Should you have any questions regarding this process, please
contact me at (714) 754-5273.
Thank you for your cooperation.
Sincerely,
Y anda Huapaya
Permit Processing Specialist
77 FAIR DRIVE
Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245
FAX (714)556-7508 • TDD(714)754-5244
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations'.
CITY OF COSTA MESA PE T NO. TRACT NO. LOT NO. BLDG.NO. i R 4762 V22/63 50a0 T
CONSTRUCTION PERMIT 3 ;` -
Project Address o / —
ry-O t� Hl�7 lrc yPS �-" �� ` TYPE OF CONSTRUCTION �(
Owner /10„ey/,¢ K Phones'/_lc/33 0 NEW 0 ADD 0 ALTERATION r Ma
n Address LSAN�e 0 REPAIR 0 CONVERSION ❑DEMOLISH %/ ZONING REGULATIONS
Arch/Eng. License No. ❑ OTHER
DESCRIPTION OF WORK 1. , '4'P'
I Address ZONE PLNG. REF.tpTt
Contractor fT r. C• NPhtiner/ - BUILDING 2OpEIRTY LINE
P /� I �S ���� / T/. 71 3S�7U TYPE OF PERMIT SETBACK C/L ST.
Q Address /r33 6V I7,f f e_,j�N 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDETYARD
\ 0TENANT ❑ ELECTRICAL PLUMBING 0MECHANICAL
LICENSED CONTRACTOR DECLARATIONLSIIDE YARD
I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT
mencing with section 7000) of Division 3 of the Business and ❑ OTHER
Professions Code, and my license is in full force and effect. REAR YARD(TO P/L)
--3 ,,Pr7G-dr7 PROJECT DESCRIPTION
License CIasS // License No.,---Pr PKG.SPACE REQ. PROVIDED
Date /- C--•PJ Signature--LLK-/G`Z—d-L. , !-✓n I SQ. FT. -
WORKERS'COMPENSATION DiCLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH —
PARK FEE $
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE 7 ZONING APPROVED BY DATE
certificate of Workers' Compensation Insurance, or a certified copy
thereof(Sectioyi�n,3800 Lab.C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS:
y No. V C44—(1-0 Company (JPf)'✓2lp �i✓2.5. C... ., ._ ' —.2/addled copy is hereby furnished. REMARKS: L J
l, f)�
Certified copy Is filed with the city Building Division.
lImm I I LSI( ____
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ''1Lu"y s1
(This section need not be completed If the permit is for one hundred r `�
($100) or less). '
I certify that In the performance of the work for which this permit is
Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK
subject to the Workers'Compensation Laws of California. DWELLING GA HHGE
Date Signature BATHTUBS SHOWERS SO FT SC) FT
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must ' TRANSFORMER
• forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+KW
revoked.
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1.10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 +HP
formance of the work for which this permit is issued (Section 3097
Civ.Lender's
� `'` w� ,-N .,^ FLOOR SINKS - `'FLOOR DRAINS ' FIXTURES OUTLETS SWITCHES
Civ. C.'s Na rrie--ti_ _ -
Lender's Address - . - . . • .'DRINKING FOUNTAINS ' GAS TUBE SIGNS
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS '
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUINSI KUL I tow
Any city or county which requires a permit to construct, alter, POLES METERED SUB
Improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB
quires the applicant for such permit to file a signed statement that he
is licensed pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETS - SERVICE - AMP •
(Chapter 9 (commencing with Section 7000) of Division 3 of the
B.'ciness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT aO - '
for the alleged exemption. Any violation of Section 7031.5 by
applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS -
.it more than five hundred dollars ($500).
LJ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS
sole compensation, will do the work, and the structure.is not Intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. • ISSUE FEE '
Contractor's License Law does not apply to an owner of a property
who builds or improves thereon, and who does such work himself or ISSUE FEE 3 ;)(� APPLICATION APPROVED BY DATE
through his own employees, provided that such improvements are not
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECKSUMMARY OF FEES
is sold within one year of completion, the owner will have the burden
of proving he did not build or improve for the purpose of sale). BUILDING
HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $
❑ I, as owner of the property, am exclusively contracting with AND DUCTING - i
licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHEC1Las'.d PERMIT
and Professions Code: The Contractor's License Law does not apply to — O—L+. s' �/yV ISSUANCE $
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBIN $
tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $
the Contractor's License Law). 100,000 +BTU PLAN CHECK $—
❑ I am exempt under Section B.& P.C.for thisBOILERS BTU ELECTRICAL $ $
reasonPLAN CHECK $
MICROFILM $
Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE$
•
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM _ MULTIPLE MECHANICAL $ -
VAN E P
information is correct. agree to comply with all city and county PLAN CHECK $ LESSA - $_
ordinances and state laws relating to construction,and hereby authorize
representativ s of this city to enter upon the above mentioned
property f ns ectio,n/purp se5,/.,[ �./ /'
Signature 'T v� �7"✓'4">''41 Date/—/ —Q.0 FINAL FEE $
Drivers' License or SS nh ISSUE FEE • '//
•
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor re'�c"O.7 bT'_y�.a ?.0 e- _
Z'
CONSTRUCTION AND PLANNING f jw POOL&SPA _ .
APPROVALS Permit# ua..--"-�ln'spector APPROVALS Permit# - Date, Inspector
•
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil Pipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45, Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding •
5. Steel Reinforce 47. Rough Plumbing & Pressure Test
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn
8. Foundation 50. Gas Pipe, -❑ Undrgrn,Test
9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, ❑'Undrgrn
10. Structural Floor System 52. APPROVAL TO DECK
11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final
12. Street Sewer Connection - ' 54. Heater & Vent-Final
13. Rough Plumbing r5. Plumbing System - Final
14. Rough Electric-Conduit -56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final •
16. Rough Heating & Air Conditioning b8. Fencing &Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing -
21. Roof Sheathing
22. Frame and Flashing NOTES: L
23. Insulation -�3 L27d4.0 / ASO ' -
24. Lathing & Siding yarn,- 440y AiO Nor GET mf IN ' 4/L/', LEp
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test _
31. Final Plumbing •
32. Water Service-Final -
33. Gas Service-Final
34. Solar Domestic-Final
35. Landscape Sprinkling System
36. Sound Attenuation
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No Date
i82Q rEE RECEIVE®
COSTA MESA BUILDING `DEPARTMENT IOP'- I t(-S�'
P.O. BOX 317 FINANCE DEPT.
COSTA MESA. CALIFORNIA OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING208 Amherst Read- I BUILDING
ADDRESS `
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO.
OWNER Princeton, Inc. 71:4a)
RECEIVED BY DATE RECEIVED DATE ISSUED
ADDRESS 419 E. 17th St. ------n-----/------n-----/ /p_/sG-4,--'OCT 1 7 1958
CITY Costa Mesa, Calif. Try }�p_ a•r . 8-1159 BUILDING
ADDRESS
ARCHITECT Carlson-1kOR ENGINEER dd1 ebrook NO.
COSTA MESA. CALIFORNIA
*Unix Garden FIRE
ADDRESS TT��*Un,pi�x Grove ZONE(
CONTRALTOR
DikeuC+�1egrove, I�`.Y Np_ T=841 CONEI` I NO. 4.7 TYPE GRO(P
ADDRESS 419 F. 17th St. NO. �•� • 8-1159 BVPROVED DATE
x/�{!�
2
LEGALLOT CORRECTIONS
DESCRIPTION NO. 23 BLOCK TRACT 2955
A.P.NO.
SIZE NO.OF BLDGS.
OF LOT 75 x 100 NOW ON LOT none
USE OF l
EXISTING BLDG. '
SETBACK LINE FROM
CENTER OF STREET 501 REAR YARD 301
SIDE YARD RIGHT 5! LEFT 201
DESCRIPTION OF WORK
NEW % ALTERATION ADDITION
REPAIR ry MOVING DEMOLISH
BUILDING NO.OF
SIZE 1365 sqft ROOMS 6 STORIES 1
EXTERIOR WALL ROOF
COVERING Stucco COVERING Comp.
USE OF NEW
BUILDING Single family residence
with attached garage.
Plan 110BR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS C RECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STA LAWS REGULATING BUILDING CONSTRUC.
TION. VALUATION �j
SIGNATURE OF %J{�'`/1/_ J'v7y�/J-7'`�/o PERMIT FEE $ 32.00
PERMITTEE ^��'%G �1(%'s'^'' /
}L
$13,919.00 PLAN CHECK $ 16.00
AUTHORIZED AGENT & Colegrove. Inc. TOTAL FEE $ 48.00 yOMF
D]J��
OWNER YALE PROPERTIES DATE 10-17-58
JOB ADDRESS 206 Amherst Road BUILDING PERMIT NO. 1820
GENERAL CONTRACTOR Dike & Colegrove VALUE $ 13,919.00
AP. No. LOT 23 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Res. & Gar.
G^nUP I &/�GJJr� TYPE V ZONE R1 PLAN NO.
1 ECT N_ SV „/ DATE PERMITS ISSUED
^NY✓"- _/ � SUBCONTRACTOR DATE NUMBER
Trenches ✓J Forms/Y(_ Steel ✓ �V — /e..4ws Y
Floor System _ti �
Steel Reinforce Chimney Re-Rod
Bond Beam ,t
Frame and Flashing � St- fraglirjr:SC(
Lathing, In A.' Out - /�/ �jq'
Plaster, brown coat r 'J-/,3i5/ _
Underground soilM WIG Pipe T34 /j. f15/
Top Out /-"ki-6 r
Furnace La- / /7 mitt 6,, la-N-31 -777 0 / '•••"-
Gas Vents CI pm �7
Rough Plumbing ,44-74-cz
-c / -// '& k :Due (2 ,i� p
. _OCT 17 958 1_6246
Cesspool Septic Tank /
Prop. Swr. Line House Con. St. Swr. ,o/s/y.4 2Nxf. NOV 7 1458 15265
Sprinkling System
Heating Final TJ
P" 'ng Fixtures, Final .4V- l'Sas Test ' LS:tii4
L/, 4?S9i
Cu.....ruction Pole
Underground Power . t
t
Rouh WirJ /2,//43-Ce J ,TN6�Oe24, ^�_1/ 7 195$ J391—ti
Fixtures, Final 21e*5 ,Q-7/'"
(/
OCCUPANCY 4-:G✓ r--3-b9
Form 210-5M-1-57 . "fl2U
9381 Rtc��V
COSTA MESA BUILDING-SAFETY DEPARTMENT V MAY 22 i959
P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT.
Y OFA MA
FOR APPLICANT TO FILL /N COMPLETELY APPLICATIION�FST
OR PERMIT
Q'
TYPE OR PRINT 1/ BUILDING
A DDLE RIDE]
2.08 prkih,efrs p{�ry,�c A
COSTA
^E MESA. CALIFORNIA(' FOR OFFICE USE ONLY
OWNER I/11(IC/I RE- f Z f a`RJ RECEIPT NO. PE
9381
MAIL ^J oC/ ���`�.�i.iC\� (/n - R FJVED BY CTE RECEIVED a DATE ISSUED A
ADDRESS �/ a D I / / ‘......N.
( J 7i/ -_1- J - 7i/-.c 7
//_ /� TEL. / BUILDING '
CITY L I •. I NO.�/1� 70 ADDRESS
ARCHITECT LIC.7�'
�, q COSTA MESA, CALIFORNIA
OR ENGINEER NO.
ADDRESS ZONE Adlli;j,re ' Group
CONTRACTORLIC.NTO. BYPROVEDPis+• DA'pE /,/�L,�•/S2
ADDRESS .�.•f rJ alto Ai-A-
a-z-fIller
Do 1 L p i/"T•->
LEGAL ILOT / 3 I I p95� ZONE �++N O._OF IV IV CEiOF NE
DESCRIPTION NO. !� BLOCK TRACT f I P6ANS BUILDING
�— APPROV Ettt /
A.P.NO. BY ,(/` //,/9�Q DATE t) - >4-'1 7
SIZE of ✓ /QQI INO.OF BLDGS. / YARDS CEV29."`"t'
OF LOT P//�/''�'�)J) NOW ON LOT REQUIRED ALLOWED
USE OF 0y� 1pc. )CG (CENTER LINE ST.)
EXISTING BLDG. CC++�D/ /X� S/ FRONT �FT. IN.
SETBACK LINE FROMGOT
7�11 SX)
CENTER OF STREET REAR YARD ! R.SIDE J`�FT. &l e— Irv.
� 'I
SIDE YARD LEFT �S/[V RIGHT S L.SIDE �FT. IN.
DESCRIPTION OF WORK �� //
`x/ REAR 3 d FT..112-757
+ IN.
NEW 1 / 1 ALTERATION I II ADDITION C
REPAIR 1 V MOVING I DEMOLISH I
SBIZIE DING /345.02, NO.OF ROOMS ...5 STORIES /
EXTERIOR WA5rc c(J 1 ROOF voce/
COVERING COVERING /�
USE OF BUILDING AND WORK TO BE PERFORMED / I _.--1`moo o aa -2-s ` :coo _
S CC} roof01/Cr -rro l-1 t'L1l c'_ gam/
5[dscLxjk app VoAc 1 •
I HEREBY'ACKNOWLEDGE THAT HIVE READ THIS APPLICATION
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STA H AI SHAT THE ''•V 1S CO:RECT AND AGREE TO COM-
PLY W )ITY,,•- .N CE- TATE LBWS REGULATINGPURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CORUC 10V A 1SIGNATURE / • PERMIT FEE $PERMITTEE ///��`///III
V$ c ..� PLAN CHECK $ ....•----"--.... .......•----"--.... ...AUTHORIZED AGENT TOTAL FEE S
a
OWNER PERRY, flNAFL D DATE 5-21-59
JOB ADDRESS 2n8 Ambers. - - BUILDING PERMIT NO. 9381_
GENERAL CONTRACTOR (Turn pr-Builder VALUE § 500,0O
AP. No. LOT 2 TRACT 2955 FIRE ZONE DESCRIPTION OF WORK Slat roof over
sa. eri781k
Ir-"ECTIONS DATE I GROUP J TYPE V ZONE R1
ground Soil U.G. Water SUBCONTRACTOR PERMITS ISSUED
L. _fground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous _
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches 4/ Forms Steel r'1 .
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Sheathing
F 'e and Flashing
ig, In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final f
Building, Final n &J Mfl
OCCUPANCY
Form 210-3M-4-59 9381