HomeMy WebLinkAbout1545 CORIANDER DR - Building Permits •
• CITY OF COSTA MESA .
BUILDING DIVISION
Fkal 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: B09-00179
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 13949217 DATE ISSUED: 08/31/2009
ISSUED BY: RMD •
JOB ADDRESS: 1545 CORIANDER DR'CM '' Suite/Unit:,
Vicinity: ROOF .
Squares: 0 . . Valuation: $10,000.00
SCOPE OF WORK: TER OFF(E)ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT•ON A 5:12 PITCHED ROOF AND REROOF
WITH 30 YEAR COMP SHINGLES ON A 4-PLEX,APPROX 40. REPAIR AND REPLACE SHEATHING AS NEEDED. .
OWNER: WRIGHT,TOMMY'DOUGLAS Address:. 1545 CORIANDER DR ' - Unit:
PHONE: - - City/State/Zip: COSTA MESA,.CA
APPLICANT: MIRANDA,'FRANK_ - r • Address: 9169 EL VERDE DRUnit: :
PHONE: 714-979-1994 - City/State/Zip: FOUNTAIN•VALLEY,CA '
CONTRACTOR: ISLAND PACIFIC ROOFING - License'No. - 631472
Address: 9169 EL VERDE DRUnit: - - PHONE: . 714-557-6516 _ ,
City/State/Zip: FOUNTAIN VALLEY,CA 92708 ' - - CELL: 714.579-7663
ARCHITECT: License No. PHONE:
ENGINEER: '` - License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00 '
Reroof Permit Fee: - $181.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1:00 - - - , •
TOTAL FEES $182.25 ` . •
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 R. INSPECTION TYPE DATE INTITIALS CODER INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final , In -.A 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't:OMPENSATION DECLARATION: • Owner ID verified by driver's license. ❑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.
❑ 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 work: ' compe ration Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a
number arc-^�. person is required to descend,will be made in connection with work authorized
r••ers i /u- by this permit,and that no building structure,scaffolding,falsework,or demolition
Cartier: \ ,l/ or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
(This section need ne(ce_oyn.oderwn: ,. rc,ran,{o-eronvpuvA-ee sonars($100)or less) 2,Art 2,Sec.341,Title B,California Administrative Code).
Polic$,,Number: /N1 U I G
❑ 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 bject to I . i•rkers' com•ensation provisions of Section 3700 of
Applicant's Signature Dale
the La L- ••de, al ho r•ly with these pro
� gl
L//if Atte/ �� Division of Industrial Safety Permit Number:
���nAAA's Signature HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO 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? D 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 i u• ••ce -nd effect. a registration form for acutely hazardous materials? ❑Yes 0 No
�j�, C/ Class'#*+ '^ / (Section 25533 of the California Health and Safety Code, with some
.44;19.; , r'�%/ exceptions, requires registration with the Costa Mesa Fire Department by
, '/�� �� '���V each business which at any one time has on hand a quantity of acutely
• .cors ignalure Dal ;;.• 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
CONSTRUCTION LENDING AGENCY: 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)? CIYes 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? ❑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 ❑No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished 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? ❑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).
O 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 D 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.
al 4 eg_rI. 4 AS
Signature" Date t Y
305]-06(3107) 'AFI
W-
Aut orized Applicant Dates..
BLRDING AND SAFETY DIVI# sI
A ul0 US /3Lp6 FIRE DAMAGE INSPECTION REPORT •
(Required Prior To Permit Issuance) •
r c^ �
Address: �I 5 Y / C oy r LG `� dem Unit an, S TC
Pei ei /ter �✓`1 y' 41 /
Owner's Address (if different from above):. •
2v' /7 f. (cite//eC.& — 7/1-/- 979. 3 8xg I
Street City State
0 Structural permit required.
® Repair or replace as necessary.
O Plans required. J ?.
• Comments: / l}}..�� it o l/ "4/! C�a a�-e ` F LK. r /
(--4 Gln P!cc7rr , t& ,O,- t / l fy ,i — etc,
( Cs . r,-)U /( lo 4 //ey
P"re tk 'r/
(1/In 0-e4.0A vita , S
O Electrical permit required.
• 0 Repair or replace as necessary.
Comments:
•
•
/!
'❑ Plumbing permit required. •
❑ Repair or replace as necessary.
Comments:
A
•
O Mechanical permit required.
❑ . Repair or replace as necessary.
Comments:
. v
(
to. Nook 12- n- 011 /4- 75 (r) ' 7
Inspector Date Phone
1872-46 Triplieato:Original-Owner;Yellow-Contrator; Pink-Building Division
0014 CITY OF COSTA MESA ' r
4 BUILDING DIVISION
> • r DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
t.1
'- ! r PERMIT
vPomoo +�' B05-00004
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
•
•
Job Address: 1545 CORIANDER DR Status: ISSUED
Suite: Applied: 01/05/2005
Vicinity: GARAGE Issued: 01/05/2005
Parcel Number: 13949217 Zoning: R3 R3
Applicant: LARRY CAMPEAU ISSUED BY:
Address: 151 KALMUS DR
STE E130 Phone: 714-979-9991
COSTA MESA CA Zip: 92626
Owner: WRIGHT, TOMMY DOUGLAS
Address 1545 CORIANDER DR
Phone:
COSTA MESA, CA Zip: 92626-2467
Contractor MESA PACIFIC DEVELOPMENT
Address: 151 KALMUS DR
STEE130 Phone: 714-979-9991
COSTA MESA CA
Zip: 92626 License: 677742
Arch : - Eng:
Address: Address:.
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
REPAIR WALL DAMAGE TO EXISTING GARAGE.WORK TOINCLUDE: FRAMING, LATH,PLASTER AND DRYWALL REPORT PER BLDG
DAMAGE REPORT.
FEE SUMMARY •
Plan Check: $0.00 Calc Valuation: $1,800.00
Permit: $63.15 Claim Valuation: $1,800.00
SMIP Res: $0.50
SMIP Corn: $0.00 ' . -
Other: $0.00
Inspection: $0.00
Total: $63.65
PLANNING & ZONING '
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0' - Left • 0-0' Right'- 0-
ACCESSORY Front 0-0 ' Rear 0-0 .. Left 0-0 Right 0-0 '
PARKING Existing: -0 ' Required: 0 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
2446-46(6/00)
J -
DECLARATIONS " n (T
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
'�yywork for which this permit is issued.
WJ .P have and will maintain workers'compensati n insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My work '�ompp�tion Inspracam and policy number are: 0.c u .. . _/- V ,
section need not be completed if the permit is valued at one hundred dollars($100)or less.) "
O 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 subject to the workers'
compensation laws of Ca' • ia,and agree that if I should become subject to the workers'compensation provisions of Section 37 0 of t e Labor Code,I shall fdrthwith
comply with these pro
pkreM nature:— -�, _ 21( Da°::!`. - / ci (j
FAILURE SECURE WORKERS'COMPENSATION COVERAGE I NLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DO ,,:'($100,000),IN ADDITION TO THE COST OF COMPENS TION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereb :i'v .Lt.am.flcensed,u••er• ovisi•n •f C =pier 9(commencing with Section 7000)of Division 3 o sines d Professions Code,and my license is in full
fir: _
ICI antl'effeci,$l9crg,` - _ /r
SAM 2! Ter a
CONSTRUCTION L NDING 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).
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)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).):
O 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 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:
❑ 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 California Health and Safety Code requires,with some exceptions,that a Business Plan be tiled 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? ❑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 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 It 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 a plication a permit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency'? U Yes LJ 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 0 No
(If ryes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality 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 0 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.
Signator: •fLe•.I Own: �> ate
liri s. TittioTizedripplicant— l/r7-
CODE r INSPECTION TYPE DEE jNIITI.ALS COPE r INSPECTION TYPE PAIL INTITIAL@
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 " -50-tO / j
_...
'[ B. _DING AND SAFETY DIVLS ,,N
A 'SQ S Rib/
FIRE DAMAGE
INSPECTION.„. OR `
s ( redPrr To Issuance); ' •
•
• Address: �I / I r Coe' LG did-ev. Unit: �'` vCt s *CCC
PeiOwner: I et S t✓k1 ''1" 4 �T
r ,: . Owner's Address (if'differerit from, above)::, s. .+ .
• 2t7 /7 _ S• ' Ceftd-eiiti CAI 7/'/' 979. 3 wyg ,
Street City State •
.® Structural permit required.
® Repair or replace as necessary. . .- v
❑ Plans required. •.. �,�yy, / C' . '
Comments/: • A ttov 'Y// . d0.414aa-e rke-i. 41, r k-/
• t47"1t �Gs•{rv� iht -. • />.1� // v•e/x, .� -e—k.• f S)J. �,� �( /0 4-// y
p4'gr'f'f .
(file 0e4 o A V"egl r r �,'
❑ Electrical permit required. - .
E ,Repair or replace as necessary.
Comments:
/ ,•
N❑ Plumbing permit required.
• `❑ Repair or replace as necessary. -
A
' Comments:
•
, - /
•
❑ Mechanical permit required.
❑•_Repair or-replace as necessary.
Comments: ,
l '
•
C, nt0 /4o- o .k • I2- 28- oq 1 /c(
�� - 35- w (r) f7
Inspector ' ' ' Date • - Phone
•
1072-45 Triplicate:Original-Owner;Yellow-Contrator; Pink-Building Division -
City of Costa Mesa
Building Safety Department CERTIFICATE OF OCCUPANCY N° 1773 C
P. 0. Box 317
Costa Mesa, California
The Building located at 15+5 Carimttr?nn• Atte` mitts A to B
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group 1; P ej Occupancy.
Use of Building t . . - . ... »., T '- . .s.:rs t _,cosarl a. - .
Legal Description Tract 545 — jot 2
(See reverse side for Metes and Bounds)
Building Permit No.P % } Electrical Permit No. esti- Plumbing Permit No. WS",
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 ooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article 8.
Number of apartments— I� and/or guest rooms • -_
ISSUED TO: Building Offi '•I
by ,Aitar i Or i�� 1
Date NV-U3.4 15;65
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. Form 3U39—IM_11-e3--s-B P
' 23256 . FEE RECEIVED
FOSTA MESA BUILDING-SAFETY DEPARTMENT DEC 1
P.O.BOX 317 COSTA MESA.CALIFORNIA . 'FINANCEE 984 DEPT.PT.
CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING /,r / %/t �✓ 1 ,I
G� For Office Use Only
ADDRESS �•S -T`A ( l� IJc`(t RECEIPT NO. ��PEg MIa
COSTA MESA, CALIFORNIA - ,J(
` y/'\ RED NY DATEREC VED DATE ISSUED
OWNER /6/9L J< c;--- (JIUCG ,. 00,e/-• �,6,c,- nEr 1 _
MAIL ADOR85S /Jr�9 .(_
ADDRESS!! DHy
CITY /— t/L(_L`ia >--,0 Ai NO. t7/JZ'r_ ZONE TYPEr ROUP FIRE gfi
APPROVED
ARCHITECT TEL. BY DATE
OR ENGINEER NO.
• ZONING
•
ADDRESS ZO NO.OF.t USE Or NEW L J'4
,\. // \. ` I PLANE I BmLDI Ii1)G AA 5Ccv1 . .
CONTRACTOR 'j- 4/ ` .0.i evej%/4—C
/ LEGAL r Z I C•�
ADDRESS,./.44"Z' -- • L� V G L , DEeCRIPTID{� lit/
CITY / CI 4j_ , g I�P-2
A.P.NO. �
NOTE: NO EAVV E/OVERHANG SHALL BE LESS THAN
STATE '1� NO.TEL 4'7 C .- LS 30"TO SIDE&REAR P.4,.
SIC,NO. ii/D L (c
SIZE p// q �I{ EAVES
OF LOT /'/ =.3 / x /C /. - ISI N .OF LOT d^ ALLOWED (U.B.C.REQUIREMENT)
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L/S-TRREEET
SETBACK LINE FROM • / I FRONT .S LFT. FT.
CENTER OF STREET S Fi REAR YARDyy /6/ /'
SIDE YARD I LEFT Y— - I" RIGHT //-..- / ` R.SIDE FT. `>-" 'I FT.
DESCRIPTION OF WORK . L.SIPE (9' FT. Ft.
■ /� `
REAR /ALTERATION _ ADDITION 0 FT. Ff.
NEW .
- DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGB:
BUILDING 116/V 77
RO MS 2Z STORIES 'L CS
SIZE !� U.P.# APPROVED
EXTERIOR N[ ROOF /'+�� APPROV'f' (� � ��� /
COVERING IIXrO COVERING 52' AP ��•p , UAA4I DATE //SDI/-(
USE OF BUILDING AND WORK TO BE PERFORMED R
.12 /L`y' vl!/J ' e,)g e/16''ig
`�yl 7z Lrar D ZN 4 +' 1E6-71SQ.FT.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE F
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. . O
PLY WITH ALL CITY ORD .ANCEB AND STATE LAWS GULATINGpCVALUATION J� �/ m
BUILDING CONSTRUFTIDN." / Y "
SIGNATURE F /�,�� /VPERMIT FEE $ O
PERMITTEE_,,._ / �v `" "v '/Y'.//� /// G
'$' �/J /,L/ PLAN CHECK $ Imo/ E
AUTHORIZED AGENT /// /
TOTAL FEE •$ / /a
I-
e 23768 ' ICITY CF CBSTA MESA •
SOSTA MESA BUILDING-SAFETY DEPARTMENT. MAR 24 1965
P.O.BOX 917 COSTA MESA,CALIFORNIA
•
For Applicant to Fill In Completely PPLICDti PIT
TYPE OR PRINT Y� BOILDI
BUILDING c/I n)IL•m �.l��rr� JG r(� For Office Use Only r�
ADDRESS 1y y S &/ Tr)}�4 mr RECEIPT NO. ' BatiTIES8
. COSTA MESA. CALIFORNIA V J
Recl,Erf
BATS RECl/ED./- D}TE IES
ED V
OWNER .A6‘42— So &HU -5/2, 45 3 /7 / (/
MAIL BUILDING V5—ADDRESS /
ADDRESS
TEL. ZON
FIRE /
E TY /,,)
3 GROUP 3
CITY NO.
///nnn��1 APPROVED //
'ARCHITECT . / i Vy TEL. - BY DATE 3/ 5"
OR ENGINEER `(-'� NO. •
ZONING `(,I ,�r//f/I
ADDRESS - IO XOi OF UEE OF NEW G^'� d fjg
'Row 6 C4-/C o4 , I PLANE 1�1 BUaDIXG � n{
CONTRACTOR YlU/ Z - („~
49, 0 5 of im l el _ LEGAL to— a- _ rR Ste(7 J,
ADDRESS ^\ (//j J� J [ l / De6cBIrt10N
CITY
UD e l /S� I /V r7 . A.P.NO.NO �'—�_
STATE �l 4t' �� _ NO 2 �?1 R . 90T TO SIDE 8 REAR P.LE: NO EAVE NG SHALL BE LESS THAN
LIC.NO. "J1 l 1 �1.Z 1 J <�
EAVES
SIZE I NO.OP BLDOS. / ALLOWED • (U.B.C.REQUIREMENT)
OF LOT NOW ON LOTS
USE OF ' AV
YARDS APPROVED YARDS APPROVED
EXISTING BLDG. /fJ t/ MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
SETBACK LINE FROM /
CENTER OF STREET .5.--
REAR YARD U FRONT /OFT..
/ �"
GFT. - CFT.
•
�--"' R.SIFT ���
SIDE YARD LEFT 'I RIGHT ��
DESCRIPTION OF WORK L.SIDE ? •• - Fr.
NEW X ALTERATION, ADDITION - REAR ylr FT.
DISTANCE BET. BET.MAIN a
' REPAIR MOVING - MAIN SLOGS/ ACCESS.SLOGS.
DEMOLISH
VAR.# - DATE
BUILDING NO.OF
SIZE ROOMS STORIES C.U.P.S LAX/3
' APPROVED
EXTERIOR WALL �_. I COVVERING PT
��TE 3-\ ) --/ 1/
COVERING /- 7 IC
USE OF ILDING AND RK T,Q "ARMED
•
C .hlh wA-11 4-be L-C'1io o
I HEREBY A SQ.FT. N
%JO KNOWLEDGE THAT I HAVE READ THE APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE ' I
AND STATE THAT THE ABOVE IS CORRECT AND A REE TO COM. - PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION r - r^• 0-
BUILDING CONSTRU ON. ' /1 PERMIT FEE $ j
SIGNATURE OF . �p/4f. V.../�
PERMITTEF �!✓VM WLW \Q.� - B
s 6 0 A C EC I X
AUTHORIZED AGENT .((J 4
TOTAL FEE $ 3