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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For App/icant to Fi!l in Completety
BUILDING
OWNER
MAIL
CITV
BRANCH
ADDRESS
ARCHITECT
ADDRESS
CONTRACTOF
ADDRESS ],]S
CITV ��STI
STATE
�10. NO. 2'�'1
SIZE
OF LOT SO
USE OF
EXISTING 6LDG.
SIZE OF _
OF
TEL.
T
SUITE 10
TEL.
"�R7R�4'
CITV
LIC. NO.
INO. OF BLDCS.
NOW ON LOT .
NO.OF
ROOMS �
ROOF
COVEFING Q�
K TO BE PERFOR
I hereby acknowletlge [hat I have reatl this application antl state
tha2 the above intormation is correct and agree to comply with
all laws regulating builtling construc[ion, antl I shall not employ
any pe�son in violation ot the workman's compensation laws of
the State of Califomia,
I hereby ceriify that I am properly licensed as a coniracior untler
the State of California Business and Professions Cotle, Divisicn 3,
Chapter 9, and ffiac such licenses are in tull for antl effect, or 1
am exempt from tl:e pro sionsy f the State of aliforni siness
antl Protessions Coue, isio 3; Chapter /
Signature of , �
Permjttee
Auihorizetl A� nt
r�:, �5_�,,�,"—,:,�o,co2 � �:,t��so.14
APPLICATION FOR BUILDING PERMIT
EIV D BV DATE RECEIVED DATE ISSUI
' �-�r"✓r-�tL ,�'� �-
A.P. NO. I I� � I L�'�I � I �."/O �`
BUILDING
ADOR�E��SSp� �
`- �TR�A�CT "` � • L0T3 v BLOCK
X
VALUE
FIRE ' —
ZONE VPE GROU ^
APPROVED '\
BV DATE �� � ^
n�\
ZO NO.OF USE OF NEW �
PLANS � BUILDING (� � v
VARDSAPPROVED VARDSAPPROVE �
MAIN BUIIDING ACCESSORV BUIIDING
(FROM C�/L•�ST�qEET) /'�
FRONT �V FT. FT. ` �
R AIfIF � FT FT J
DISTANCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS.
VAR.�k DATE
QU.P.� APPROVED
APPFiOVE� �
� � � .�.
HOLD FOR ECIA r \ �
' � .
( ���
\ TAX / - {�
����j ���jjj ��_ � m
� �'SQ. FT. �"� o
THE AMOUNTSHOWN UNDER VAIUATION IS FOR �
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: m
¢
VALUATION �
PERMIT FEE $ �
K
$ �� n �ii PLAN CHECK $ E
/L�J o
TOTAL FEE 3
9/ LL
�OWNER CLARE Builders, Inc. DATE 5-8-74
JOB ADDRESS 240 Albert Place BUILDING PERMIT N0. 38017
�, r_[uooni rnr.�ronr'rno .. . _ . . . noci-oionnu _iwnov „_ i __ . ___ _ _
R 118-124-13 LOT
IN�rECTIONS
501 L
GAS
WATERNAM G�i4-7'N
ROUGH PL MBING
PROP. $WR. LINE OUSE CON.
SPRINKLING SYSTEM
MISCELLNNEOl15
ROUGH NEATING AND AIR CONDITIONING
TEMPORARV SERVICE OR POLE
UNDERGROUND � POWER �
ROUGH WIRING
TRENCHES � FORMS � STEEL REINF.
FLOOR SYSTEM
BOND BEAM � STEEL REINFORCE �
SHEqTHING
FRAME ANO FLASHING
LPTHING — IN OUT
PI "ER, BROWN COAT
5 :URAL, FINAL
SUBCONTRACTOR
VENT., REFRIG. AN� A.C„ FINAL ' IL4�b I��'lo-��l I�
. FINAL ANO GAS 7E5T �TY • �� i //..
'" CITY OF COSTA MESA
� PARK FEES
0
Fee Payment Receipt ' U 3 1
Project Address 2—� � i�L��C � •
A. P. No. � � 8 — �2 T— � 3
Building Permi[ Nu. .� � C%� /
Park Area "3 . "
Owner's Name C�–�� �C�l�-�S l Q`�L -
Mailing Address �r%� ( �2�j �N� �L. S'v\'C��O
FEE �
Single Family *
Multiple Family �`*
Planning Departmen[ Approval
Applican['s Signa[ure
• City Ordinance 72-44 V
•' City Ortlinante 72-45
No. of Units �
No. of Units
@ S338.27 =
@ $238.78 =
Total Fee
.. //i
338. 27
3 ��3. 2i
c,osGa ��csa
� CITY OF COSTA MESA �
� BUILDIN6 DIVISION \�`
f DEVELOPMENT SERVICES DEPARTMENT S� jrQ\�
°• � PERMIT � PERMITNUMBER
��
698-01583 ��
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 240 ALBERT PL
Suite:
Vicinity:
Parcel Nunmber: 42607412
npplicant: SURUKI, TADASHI
Address: 240 ALBERT ST
BUILDING PERMIT
Zoning:
Phone: 949 646-4541
COSTA MESA,CA , � Zip: 92627 �
Owner. SURUKI, TADASHI
Address 240 ALBERT ST - �
. . � � Phone: . . . .
- COSTA MESA,CA - Zip: 92627 � ' �� ' . �
Contractoc. - � .
Address:
� Phone:
_ Zipi'.
' License: �
Arch/Eng: --: � : ' �
Address: � � ,; � �� � '� '
� ' "Phone: �
� Zip: �
License:
SCOPE OF PERMIT
CONSTRUCT AN 83 L.F., 6' HIGH BLOCK WALL ON THE RIGHT SIDEPROPERTY LINE.
F E S MMARY
Status: APPROVED
Applied: 09/01/1998
Issued: 09/01/1998
. E U
Pian Check: $35.10 ,-— Calc Valuation: S�,seo.00
� Permit: $54.00 =� ,' Claim Vaivation: S�,sso.00
SMIP Res: $0.50 � � �
SMIP Com: $0.00 - _�
Other: $0.00 _ -
Inspection: $0.00 "
Total: E89.60 •
- PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 52-0
PARKING Existinq: o
NOTES:
Rear 4 0�
Rear 0- 0
Re uired: 0
Left 0- 0
Left 0• 0
Proposed: 0
Right 0-0
Right 0- 0
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned
for a perlod 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
requlred inspeetlons and finel epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
�
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v
WORKERS'COMPENSATIONDECLAAAnON:
I hereby effirtn undar penalry of perjury one of the following declare�ions:
❑ I have antl wlll meinteln e certifica�e of consent to seli-Insure for warkers' compensetlan, es provided for by section 3700 oi the Lebor Code, for ihe pertormence of the
work for whiCh this pertnit is issund.
❑ I heve and will maintflin workers' cwnpensation insurenca, as required by section 3700 of the Lebor Code, for Ihe perfortnence of the work for which this pertnit is issued.
My workers' compensation Insurance cartier end policy number ere:
Cartier: Policy Number:
(This secfion need not be comp/eted ll the perm/t is va/uetl et one hundred dollers ($100) or /ess.)
❑ I certity Ihet in the peAormance of ihe work for which ihis pertnit is issuetl, I shell no� employ any person in any manner so es to become subject to ihe workers'
compensetlon laws of Calitornla, entl agree Ihat if I should 6ecome subject to the workers' compensatlon provisions of Section 3700 of the Lebor Cotle, I shell forthwith
comply with thesa provisions.
Applicant Signeture: Date:
WARNINO: FAILURE TO SECUAE WORKERS' �1PENSATION WVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIV1L FlNES OP TO ONE HUNDRED
TFIOUSAND DOLLARE ($100,000), IN ADDITItl�d TO THE COST OF COMPENSATION, DAMAGES AS PROVIOEO FOR IN SECTION 3]O6 OF THE LABOfi CODE, IMEREST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION: �
I hereby affirtn thet I am licensetl under p�a�isions ot Chapter 9(commencing with Sectlon 7000) of Division 3 ot the eusiness end Professions Cade, an0 my license is in full
force and effact. Lic. # Class #
Conirectors Signature: Date:
CONSTHUC710N LENDING AGENCY;
❑ I hereby aXirm ihat there is a cons��+ction lending agency Por the perfortnance oi Ihe work for which ihis permit is issued. (Sec. 3097, Civll Code).
Lendefs Neme: Lender's Atltlreu:
Signature: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby elfirtn that untler penelry ot perjury thet I am EXEMP7 FROM THE CONTRAC70RS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or county which reqwres a permit to consiruct, alter, Improve, demolish, or repair any structure, pnor to Its Issuance, also requlres ihe applicant for such permit
to file e signed stetemant ihat he or she Is licensed pursuent to the provisions of Ihe Contrectors Licensa Law (Chapter 9(commencing wl�h Section 7000) of Divlsion 3 of ihe
8usiness antl Professions Code) or thal he or she is exempt therefrom and the basis for the alleged exemption. Any violatlon of Section 7031.5 by eny epplicant for a pertnit
sub�ects ihe applicent to a civil penalry 0� not more then five hundred tlollers ($500).):
❑ I, es owner of the property, or my employees with wages as thelr sole compensation, WILL DO THE WORK, entl the structure is not Intentletl or oflered for sale (Sec.
7046, Busineu and Professions Code: The Conirectors License Law Ooes not apply to an owner of property who builds or improves ihereon, and who tloes such work
himself or herself or t�rough his of her awn employees, provided that such improvements are not intentletl or ottered tor sale. If, however, Ihe bulltling or improvement is
sold within ane year af completion, ihe owner-builder will have the burtlen ot proving that he or she did not build or improve for purpose of sele.).
❑ I, es owner of the property, am EXCLUSIVELY CONTRAC7ING WITli LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
CoCe: The contractors License Law does noi apply to an owner ot properry who Dullds or Impmves ihereon, and who contreds tor such project with e contractor(s)
license pursuant to the Contractors License Lews.).
❑ lam
Owner ID veritied by dnvels license.
❑ No
Business antl Professions Cotle tor Ihis reasqn:
� Date: �— / '� � /
Drivers�License Na. Expires:
Varificetian of Ownership by (type oi doGumenL I.a. - properry tax blll or deed):
DIVISION OF INDUSTRIAL SAFETY PEAMR CERTIFICATION:
❑ I hereby certify thet no excavetlon �ive (5) or more faet in depih Inro whlch a person is requiretl to tlescend, wlll be made In connectlon with work authodzed by ihis
pertnit, and that no builtling structu�e, scatFoldinq, Falsework, or demolition or tlismantling ihereot, will be more then thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, 7tle B, Califamia AtlministreN�e Code).
❑ As owner-bulltler, I will not employ anyone to do work which would require a pertnit trom lhe Dlvision of Industrial SefeN, es noted above, unless such pe�son hes a
permit ro tlo such work hom the di�ision.
Signature: Date:
Division af Industrial Satety Pertnit Number:
CERTIFlCATE OF COMPLIANCE lWD AUfMOR¢AT10N OF ENffiY: I certity under penalry of perjury that I have read this application and state that the information given is
correct. I egree lo comply with all stete laws and city ordinences relating to building construction, end authonze representative5 of the Ciry oi Coste Mesa lo enter upon the
ab scri6�d prope for' spection pu ses. I agree not to occupy or allow occupancy.ot any 6uilding euthonzed by�s permit until tinel in� dion.
J..��.� � � .� �a
Sinnxturw OI LBa91 OwOB�(51 Deie
And/Or Au�horized Applicant
COUE1, INSPECTIONTYPE
1676 Fixed System Finel Fire Preven6on
1268 Pool SDe Final
200 Finel Re-Roof
201 Finel BIocWRetaining Wall
202 Finel Fectory Fire Plece
203 Final Sign
204 Final Damolition
2d48d8
�ff I��
� z 9 q� (LJV l�
T
COUE� INSPECTIONTYPE
206 Finel Mechanicel
208 Finel Plumbing
210 Finel Electncal
212 Final Fire Prevention
220 Final Plenning Approval
222 FinalSite
250 Final Building/Occupancy
UAiE ItII�ALS
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fl�is se! of plans and speafications I
v�ako any changes or aKora!ion on uI
�nd Saisry, Cit, of Costa Mesa. 1
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i FDDITIONS, DELETION , OR CORRECTIONS $i�Al
' DE APPROVED BY THE PLANNiNG DiVISf,ON
TYF'OCAL
Cement Coping Oouonal —'
Channel Block With 7�3/8�
Horizontal Top of all
Fences
For Fences 5' o� Less
Vert. Bars 3/8"�i at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"� ai 32" O.C.
Fill Cells Solid With Grout
Where Steel OccurS
Reinforcing Steel 5ha11
Conform to Sec.A�15-39
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURALGHAOE
TW03/8"48ARS �-'
CONTINUOUSTOP �
& BOTTOM
HO(21ZSTEEL MUST 9E TIEO IN
PLACE AT TIME OF TRENCH
INSPECTION.
4
n 'p
o A —
D
�
�
yL
� W"IDTH
� SEE CHl
9 BELOW
D' `
6�� CONCRETE BLOCK FENCE
GENERAL- NOTES
�
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MORTAR; p�e Par} Plastic Cemenf, and
Three Paris Sand
GROUT; One Part Cemenf TAree ana
One Half Parts S'ond
COPING: One Port Cement, Three
Paris Sand
c:ONCRETE: Weil M+xed 1:2-I/2:3-I/2
Max. ot 7-I/2 Gallons ot
Water Per Sack of Cement
GROUT MAV BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HOflIZONTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H GP [4RTHTCOTH
i/? iHE NEIGTH Of FENCE
BEIOW BOTTOM OF FOGTiNG
SCALE: I/2��= I'
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6� 5 4� 3'
WI�TH 14�� . . . . . . . . 14�� . . . 12��. . IZ��
TMICKNESS 10° . 10° .. 6" 8„
p�PTH OF EARTHTOOTH ... 24�� 20�� .. 16�� 12��
SPACING OF EARTHTOOTH . 12' 14' ... 16' 16'
City of Costa Mesa,
Building Departmeni
w��.:�� ��.84
California