HomeMy WebLinkAbout1974 CONTINENTAL AVE - Building Permits CITY OF COSTA MESA
el if , BUILDING DIVISION
Fy- 'SII g 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci. a-mesa.ca.us
? FOR INSPECTIONS CALL: (714)754-5626
'O+anmmo A'
PERMIT NUMBER: BX08-00047 •
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 42251244 DATE ISSUED: 02/15/2008
Zoning: , ISSUED BY: RMD
JOB ADDRESS: 1974 CONTINENTAL AV CM Suite/Unit:
Vicinity: SIDE OF HOUSE Primary Occ: - Const Type. :??
SQ. FT: 0 Valuation: $4,000.00
SCOPE OF WORK: •
DRYWALL REPAIR (LIVING ROOM, BEDROOMS, HALLWAY, 1 BATH, KITCHEN).DUE TO WATER DAMAGE, UPGRADE SERVICE
PANEL TO 100 AMP(SAME LOCATION SIDE OF HOUSE), CHANGE OUT 8 OUTLETS AND 3 SWITCHES IN KITCHEN FOR A
SFD.
OWNER: STARKS,JOAN A Address:: 1974 CONTINENTAL AVE Unit
City/State: COSTA MESA,CA Zip Code: 92627
Phone: ..
APPLICANT: BERGKVIST, FRANK Address: 4211 KATELLA AVENUE Unit:
City/State: LOS ALAMITOS,CA - Zip Code: 90720
Phone: 714-920-8417
CONTRACTOR: WESTERN STATES RESTORATION INC License No. 680382
Address: 4211 KATELLA AVENUE Unit:
City/State: LOS ALAMITOS, CA - - -
Zip Code: 90720 Phone 714-826-3553 Cell:
ARCHITECT: License No.
Phone
ENGINEER: License No.
Phone
• .FEE SUMMARY
Building Plan Check: $0.00
Building Permit: - $97.25 •
Electrical Permit: . $65.30, .,
SMIP Residential • $0.50 •
SMTP Commercial $0.00
$0.00TOTAL FEES $163.05
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: 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 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.
CODE I. INSPECTION TYPE DATE INIITIALS CODER INSPECTION TYPE GATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lick . ❑Yes ❑ No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
O 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: �J person is required to descend,will be made in connection with work authorized
rCaTrier: E- FU/�n`x O 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
(This section need no be completed it the permit is valued at one hundred dollars($100)or less.)
2,Art 2Sec.341,Title B,California Administrative Code).
tPolicy.Number: V/ '7_000 0 ' 2-Cz
0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to he woA. r L.mpensation provisions of Section 3700 of
Applicant's Signature Date
the Labor cod- I firilicor • ply with these provisions.
—/� 1�� '7 715—a
5' Division of Industrial Safety Permit Number:
07 .pit . ��Ti.ure G Date') HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
'••RNINe. AILURE Ti' SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Profe ions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license s in full for - andr- .[. / a registration form for acutely hazardous materials? 0 Yes ❑No
Lick.#_ I LiTi�iC!1. Class# �� � (Section 25533 of the California Health and Safety Code, with some
`_#5tre 2 Air exceptions, requires registration with the Costa Mesa Fire Department by
/ i- - dt �- each business which at any one time has on hand a quantity of acutely
r✓ c,�W gnature \,Date ' 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
CONS 'UCTION LENDING AGENCY: temperature and pressure).
O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
• 4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own
8. (If'yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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. Pg Signature Dale
3057-46(3/07)
V ( r ippticanl -� ( Dale -
CITY OF COSTA MESA
Fs, BUILDING DIVISION
. p
Fto 1I 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
tl, FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER P08-00007
PERMIT TYPE PLUM STATUS: ISSUED
APN: 42251244 DATE ISSUED: 01108/2008
ISSUED BY: RMD
JOB ADDRESS: 1974 CONTINENTAL AU CM Suite/Unit:
Vicinity: -
SCOPE OF WORK: INSTALLATION OF CLEAN OUT ON HOUSE SEWER LINE NEXT TO HOUSE AND REPAIR 60'OF SEWER
PIPING.
OWNER: CHANDLER;BILLY DON - Address: 1974 CONTINENTAL AVE
PHONE: 949-548-3869, •- - City/State/Zip: COSTA MESA,CA
APPLICANT: ELLIS, E J,JR. Address:
PHONE: 310-838-0408 - City/State/zZip:
CONTRACTOR: ORANGE CO SVS INC DBA GEORGE BRAZIL PLU License No. 679898
Address: 3801 LENAWEE AVE PHONE: 310-838-0408 X120
City/State: CULVER CITY, CA ZipCode: 90232 - CELL:
ARCHITECT: License No. PHONE:
ENGINEER: LicenseNo. PHONE:
.. PLUMBINGPERMIT FEE SUMMARY
• PLAN CHECK FEE: - $0.00 ' •
PERMIT FEE: - $48.15
• TOTAL FEES: $48.15
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: 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 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.
CODE S. INSPECTION TYPE DATE INTITIALS COVEN INSPECTION TYPE DATE INTTALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical ,
1266 Pool Spa Final 208 Final Plumbing )-)I-o8 P)I�(I
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lice. _ ❑Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
erformance of the work for which this permit is issued.
I have and will maintain workers'compensation insurance,as required by
ettion 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: .
permit is issued. My workers' compensation Insurance carder and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number are: /� 0061-17-
n / � 1��- INC ,
person is required to descend,will be made in connection with work authorized
Carrier_ - - �(�!� �/C�(;/ / / by this permit,and that no building structure,scaffolding,falsework,or demolition
�C__ or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
-(1seam need nor n�e J^y��e�{ties Ire a/p )hundred"an(Etoo)w less" 2,M2 Sec.341.Title 8,California Administrative Code).
Policy.Number. rV 'v I O I
❑ As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws • alifomia, and agree that if I should
become subj- 1.4.the rape •ation provisions of Section 3700 of ApWranrs Signature Dale
the Labor ..e,.� 1 comply 'th these provisions. `,
f le later . Division of Industrial Safety Permit Number:
%ppli is ignawre -Date' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE/ ORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license's in f fo e,aft• ffecl. . a registration form for acutely hazardous materials? ❑Yes 0 No
clic ir.- -'i roi Ar_ lass# •�- l] a (Section 25533 of the Califomia Health and Safety Code, with some
/�ga- � v exceptions, requires registration with the Costa Mesa Fire Department by
��)r� I�l/ • • each business which at any one time has on hand a quantity of acutely
Conra • ignature Date hazardous materials equal to or greater than a weight of 500 pounds, or a
C.---
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION L NDING AGENC : temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
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 (Section 65850.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits).
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No
thereon,and who does such work himself or herself or through his or her own 8 (If'yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code:The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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 insp=ion.
/ I i a /�
Signature - Dale �Alem� j�S�ar
fe'^/}%
cr ndi Authorized Applicant - Date •
CITY OF COSTA MESA
o ' "' BUILDING DIVISION
) 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
t. FOR INSPECTIONS CALL: (714)754-5626 ��
"�� PERMIT NUMBER. P07-00603
PERMIT TYPE PLUM STATUS: ISSUED
DATE ISSUED: 12/0312007
ISSUED BY: RMD
JOB ADDRESS: 1974 CONTINENTAL AV CM Suite/Unit:
Vicinity: HALLWAY CLOSET
SCOPE OF WORK: WATER HEATER:CHANGE OUT IN HALLWAY CLOSET FOR A SFD.
•
OWNER: CHANDLER, BILLY DON Address: 1974 CONTINENTAL AVE
PHONE: 949-548.3869 - City/State/Zip: COSTA MESA,CA
APPLICANT: ELLIS,JOE • - . Address:
PHONE: 310-838-0408 " ' - City/Stale/zZip:
•
CONTRACTOR: ORANGE CO SVS INC DBA GEORGE BRAZIL PLU License No. 679898
Address: 3801,LENAWEE AVE PHONE: 310-838-0408 X120
City/State: CULVER CITY,CA ZipCode: 90232 CELL:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE: $0.00
PERMIT FEE: $35.80
TOTAL FEES: $35.80 R R .
• • •3
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: 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 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.
CODE I. INSPECTION TYPE DATE IN11TIAL6 CODE* INSPECTION TYPE DATE INTInAL
1616 Fixed System Final Fire Prevention 208 Final Mechanical
1288 Pool Spa Final _ 208 Final Plumbing I`r�^-(3..17 BIj
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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lir, J. El Yes El No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property lax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
ge ormance of the work for which this permit is issued.
I have and will maintain workers'compensation insurance, as required by
s tan 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy El I hereby certify that no excavation five(5)or more feet in depth into which a
number are: Font) person is required to descend,will be made in connection with work authorized
C ' by this permit,and that no building structure,scaffolding,falsework,or demolition
67-11/(6-: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Gry
(This section need not be pleletl/e/ per(m/a is�+g-ued�ay/pn/e�nuunnddre dollars(POO)or less.) 2,Art 2Sec.341,Title B,California Administrative Code).
Policy:Number: ��' { `-( (]- //CJv /
❑ As owner-builder, I will not employ anyone to do work which would
El I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws • alifornia, and agree that if I should
become s ct to t•- ' ,•mp•nsation provisions of Section 3700 of Applicant's signature Date
the Lab• .her corn•y with these provisions.
�� S.A. /2�3,-,O-7 Division of Industrial Safety Permit Number:
:p halt's Signature GDatev. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECU" WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes El No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in f I fort- an..effect. /J a registration form for acutely hazardous materials? ❑Yes D No
L�ic'_-- i,tate. �- GClass#:e's- f� (Section 25533 of the California Health and Safety Code, with some
ii"I I l, ,L ,7 exceptions, requires registration with the Costa Mesa Fire Department by
���///►.-. n- "07 each business which at any one time has on hand a quantity of acutely
i'" Con ra.,f. a'ure 'I ,-Date---•=+ hazardous materials equal to or greater than a weight of 500 pounds, or a
1� volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CONSTRUCTION LENDING AG CY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ElYes ElNo
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE '5. Does or will the applicant or present or future building occupant require for ,
CONTRACTORS LICENSE LAW for the following reason (Sec.'7031.5,r: the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires•a`permit to' ormodification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair;any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No
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 (Section 65850.2 of the California Govemment Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
information be furnished on applications for non-residential building permits).
Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes El No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California
License Law does not apply to an owner of properly who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No
thereon,and who does such work himself or herself or through his or her own
8. (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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.
ifr e Y • Date
Signature - Date �.- 7
'fie /2-37
305]-061310])
'M -
Wine,'thaized Applicant - Dale
=-771.w
. OWNER DY$FLT,, LOUTS A MAR 11 1957 DATE 7_16-56
JOB ADDRESS 197)1 Cnnti nenta1 Avn_ BUILDING PERMIT NO. #1335
GENERAL CONTRACTOR Own pq. RT Ar VALUE $ 910 no
AP --
LOT BLOCK TRACT .• • . - ' • •
GROUP J TYPE V ZONE T1 FIRE DISTRICT 3360
INSPECTIONS DATE SUBCONTRACTOR _ PERMITS ISSUED
a DATE NUMBER
Footing Trench &- f --I 73e-�
Foundation Forms and Grade to Garage
Rough Framing 9-a3 4 6 /
Plumbing, Rough to Slab _ ,J ,�_ f,JQ, ,tea 8-17 SL a 08y .�
Plumbing,Rough Complete .0 Cl" to-kit,
Temporary Pole _
Wiring, Rough
Heating,Rough _
Heating, Final _
Sewer, House Sewer, St.
Septic Tank or Cesspool
Lathing, In Out � r4 J'
Plasteringr
Plumbing,Final,Fixtures Complete .0ec,�•- • - •
ii
Plumbing,Final Gas Test Lr
Wiring,Final y�
Occupancy a�ri 8 3- •
FORM 210 3M TO-55 3331
Costa Mesa Building Department APPLICATION FOR PERMIT
4.;= P. O. Box 3U 3360 BUILDING 11
COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN 1 Receipt No. I Permit No.
Building/7 7y/7 /1 3.3 3 ,�
Address ( (�,1J.,�
Costa Mesa, California -
Received by Date Reda. Date Issued
Nearest B J /6IsF'J
Cross St. Building
a. 0 I / Address
Owner s.r-u.aCosta Mesa, California
Mail /9 7,j _ / 1 /•J
Address• es�1 .l..QQ../ ma�yy,,,,,,"" IN//"c Nearest
City ea-0. trt. dfrinA ,o1-• No.F7. 6 f07 Cross St.
Y ZoneR) No.of Type Grouj
Architect or Lic. /� /{ I Plans
Engineer No. Approved
by - w A vay to
Address j��,...�g,J� /1,i1��1{LbDlfil.•
City Lic.
Contractor No. CITY OF COSTA MESA
Address '-�— PLANNING DEPT.
LSUBJLLI IU tULUG. DErT. REG.
DescriptionLegal I Noto.4 ,/ I I Block Trac,/ �- �,,p 7
(Attach Metes and Bounds) _ .RY.__%L�- - DATE /3/S.6
No.of Blilts.
AN T:grt- '--
Sizeof Lot Gal X hip I Nowon \ A s Kr A t R _
Use of No.of No.ofj, i 9
Existing Bldg. O. 7t&., I Famill I Rooms /
Setback Line from FRear. Yard
Center of Street J O Side Yard' a
DESCRIPTION OF WORK �.
New I I Alteration I I Addition I/, `!- -- - - 3 1
_VAR Nn � '/Z DATE
Repair I I Moving I Demolish I 7 ArrROVED _- _
SizeBuilding/7 I� aG Rooms Stories /
Exterior Wall , Roof
Covering . t.,pI Covering , APPROVALS
-
Use of New
Foundation Location/,--1 flns.pect ,
• DateBuing rag- Forms,Materials,:y ---1 ,` / �.
d� , Under-Pinning _ \ �S / i. hl.
Frame: Fire Stops, ,`;�,, C)4• f
Bracing,Bolts , ! i
I hereby acknowledge that I have read this Application ,,//11 (-14. , .S* �'
and state that the above Is correct and agree to comply Lath.Int.CM/ _ 9.-3
with all City Ordinances and State Laws regulating • i
building construe tjgn. i.1 Lath. Ext u!- -?,)0..,
Signature of �`,/,/� a -1/4 .0/4
Permittee �'u't'd Plaster, Int �7 �/',(`e, ,
,iJ4
Authorized Agt Plaster,Ext.
Valuation Permit Fee $ 6 -- Masonry Reinforced
t• /,2/ Plan Check $ • '..--- Bond Beam
$ Total 4 .—
Fee
Fee $ FINAL
YORM 204 10.55 0.P.&S.
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ORyANGE COUNTY BUILDING DEPARTMENT APPLICATION FOR PERMIT636 North
dway
SANTA ANA, CALIFORNIA BUILDING 1
FOR, APPLICANT TO FILL IN FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
BUILDING
ADDRESS 1974 Continental Ave. 67, 4/951-0
SCHOOL DIST. RECEI�ED BY DATE REC'6 DATE ISSUED
OR TOWN } pT syr /� �}•
CROSS NEAREST. 20th}4L�trbet e_tR1Ct3 Luso
I/G CJ 19 /3 F-Mn —///3�y�/3
yyamj�.....� (��L�y33�9��$y[ hh xa BUILDING �i // / Lz:;S-F-
OWNERJ[y (�gJE][j� $JLl�jy[�• ADDRESS i /ifw,
MAIL
ADDRESS 936R Wilshire BlvdORH OOW DIST. •
CITY Beverly Hills No`CR 54361 NEAREST IWIL ,,�a(it—.717
ARCHITECT"' ORy,� p CROSS ST. I
ENGIiNEEIVain & MoKerrachaC. ZBt5fl x ZONE NO. O TYPE GROUP
7 / I PLANS ^"/j_ I j 3
ADDRESS 2110 E.Walnut-Pasadena APPR �/ �y
*�'1 BYPROVE DATE V _/p q 9
CONTRACTORNewport Vista 10135882
ADDRESS
9363 Wilshtre-Beverly Hills CORRECTIONS
LEGALLOT
DESCRIPTION I NO. 454 I BLOCK I TRACT1712
(ATTACH METES & BOUNDS)
NO. OF BLDGS.
SIZE OF LOT 67 x 110 I NOW ON LOT 0
USE OF I NO. OFNO. OF
EXISTING BLDG. FAMILIES I ROOMSc�SETBACAA}}(�
CENTER KOFINE STREETMI 50 ft_ SIDE PARREAR S V-1V/
DESCRIPTION OF WORK 0
NEW I X I ALTERATION I I ADDITION I O
2
REPAIR I I MOVING I I DEMOLISH I r
BUILDING 1034 afl.o O O
5SIZE STORIES 1
EXTERIOR WALL C I h ROOF CQInn),gpo
COVERING Sto uccCOVERING ie
USE OF NEW
BUILDING Residence
LAi'-aA��/ (OO-r�
0 APPROVALS
FOUNDATION: LOCATION INSPECTOR DATE
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS FORMS, MATERIALS, /JA Y if'/�/�
APPLICATION AND STATE THAT THE ABOVE IS CORRECT UNDER-PINNING ,J(� \�f [
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRAME:BRACING.STOPS,
BOLTS .� �F ¢ �` '�`
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. /{ t
LATH. INT. -/-(2.04) ? 6-.'1 5
SIGNATURE OF Newportainiiito Co.0LATH. EXT. •'(!�� L/ '� r�
PERMITTEE N PLASTER, INT.
((ff�� J
AUTHORIZED AGT/ • el• 8 //n � T .c �
.(/ C� PLASTER. EXT. GS- /S.- -0
PERMIT FEE 5 MASONRY REINFORCED
VALUATION 54830.00 PLAN CHECK $
/ BOND BEAMTOT ,-*--M
� /`
FEE S ' I FINAL /��// - '�
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property line and between buildings.
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