HomeMy WebLinkAbout1984 BALEARIC DR - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.•
I•
tyf�'/2 3/19/U/
CITYQF COSTA MESA q CONST UCTION PERMIT PERMIT 7786g TRACT NO. LOT NO. UNIT NO. '
r Project Address /Q .. y /.�.e 4r1C D� . E
'• +yam / TYPE OF CONSTRUCTION LJ NEW LJ ADD LTERATIO LJ REPAIR
Applicant's Maillr.[4ddress +'rl�G? /Y` S..gJ�Phone G�-�d ❑ CONY RSI ON CI DEMOLISH ❑ OT. R ' A.P.# Zone
DOwner's Name ^�-7 f t-� b0�4LC: Phone � 0 _yr.Q c,'t CJ ._
p ,p . , , •N OF WOR USFOFBLDG. •
Address /9p Y .84--Cator. G is. �i 'r .aa < CLT • - ES Main Building: Accessory Building: Z
Arch/Eng. Li nse �e�' �'+�+� TYPE OF PER T . GRADING ❑ FOUNDATION Li STRUCTURAL T Front o
Address 464Y1 ' J ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
s• ❑ OTHER A I
Contractor's Name PhonA/7 7�''�'_"e(/� / C Right N
-1,, Uf„ C I PROJECT DESCRIPTION SQ. FTc (p 6O OCCUPANCY
Address lmailingl�i/d A S 9k r.4.Hs e;4—ga i / K G
�� / f CONSTRUCTION TYPE VALUATIONS p a V ' S Left R
City License No. ZONE GRADING CU.YDS. ACRES .
Ping. Ref.# Parking Req./Provided E
LICENSED CONTRACTOR DECLARATION Q
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes:
with section 7000) of Division 3 of the Business and Professions Code, and M
my license is in full force and effect. w T
Licens Class ,, '.ens: .. 4.5 ." `S
Date Sig aturLWN V...8.-. - - PLUMBING FEES
WORKERS' COMPENSATION DECLARATIOj s I Bar Sink Showers ' `
hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
3800, Lab. C.) - Automatic Washer Transformer 0 15-50 KW
Policy No. Company Backflow Irrigation Sewer Ca 050+KW
BCertified copy is hereby furnished. P DOnatrUCtiOn Pole Sub.
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps
Date Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed if the permit is for one hundred ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this p- it is issued, I
shall not employ any person in a ner 0. o o Object to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1'/x-8
Workerai Corp nsation Laws of Ca ' orn
Date J`F' —y Signature '_-� —+ e Floor Drains Swimming Pool w/Spa —
F.A.U. • Inc.Solar LJ HP 016-15+
NOTICE: If,after making this declaration, you uld eco ( subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes
I hereby affirm that there is a construction lending agency for the performance Pole Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets
Lender's Name Range
Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION -
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or - 9 P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit P
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code) or that he/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). •
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3
for sale (Secion 7044, Business and Professional Code: The Contractor's ' MECHANICAL FEES •
License Law 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 DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date_
prove for the purpose of sale). Z
❑ I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ( Dat
tractors to construct the project (Section 7044,Business and Professions Code: - -
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUM A Y OF FEES ,
builds or improves thereon,and who contracts for such projects with a con- (� OE
tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ +�V
proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple ❑ System Repair/Alteration PER $
PLAN CHECK $ PERMIT
0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.BIL ICBG# Fire Dampers• PLUMBING $ ISSUANCE . $ -Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00100,000 BTU 0100,000 BTL ELECTRICAL $. GRADING $
information i orrect. I agree to comply all city and county ordinances
and slat ws r g to building const on, and hereby authorize repre-
sentative of this a y„,�fD- a tbr dp n above-mentioned property for PLAN CHECK 50% $
inspectio p / 3—/9 -5'7 ._ MECHANICAL $ TOTAL FEE $ ^Sb
Signature ./ �,] Date Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' License or SS# / p
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
•
CONSTRUCTION AND PLANNING POOL &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 Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 Drains 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 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 PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
•
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 t .
45. Sound Attenuation •
46. Handicap Regulations -
47. FINALSTRUCTURE & BUILDING /0/9 -7 0 '
48.?Special Requirements Completed /
49. Electric Release to Edison
' 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
1 No. Date es
ROOF COVERING CERTIFIC. JON
-. •
�,/ Permit No. 8c77n
Property address
/ 9 0 g 75.4"{ee r 'rc b r-
Owner /J i ( C. Vrt c Do A146Cl
Contractor a 4 .- S o ` ~y ` , LC .3 j xt'e r
State Contractor License Number "&'C6G Classification C.— 3 I
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 1979 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).
H I further certify that I am:
Owner of sole proprietorship company
❑ Full partner of the company
E 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.
ecc a- ci ,
Company or Corporate Nanite
4'd et.// S
Address
(Or ea Ca- c? L G7
Received by Building Division by' Signature p - Date
— 3 /�� �, ..p I-L Lf/ . r6 e
Initial Date Printed or Typed Name
Space far Notarial Statement for authorized officer or agent
CMF 0990-46 White-Building Div.;Canary -Contractor;Pink-Owner
Applicant to fill in all spaces except thosewithin heavy border lines and sign all appropriate declarations.
•
_f PERMIT NO. TRACT N LOT O. UNIT NO.
CITY OF COSTA MESA CONSTRUCTION PERMIT
/ IG84 sAIeAP1C Q12 . ' .'Pr lq?02i (-E-3�->, 1 -• 369C /Iii •
Project Address !'� iVf - _
Applicant's Mailing{�Address IG' t \ B i I:''{s�v t,,, TYPE OF CONSTRUCTION ) NEW H ADD H ALTERATION H REPAIR
.. Owner'sName - 1 ILL kP. DCLIAl ❑ CONVERSION 111 DEMOLISH El OTHER - (``
PhoneG(D(o l g�6 DESCRIPTION OF WO /USP OF BLDG. A.P.# 1T7� — (,���.-�S Zone
• {`lddress 13IGc3 t4 BAienp 1C C ' t-1 es" befit t,lyo-t..f_1 11%70 d`Sp4' - S Main Building: I - - Accessory Building: Z
Rrcli/Eng. CAI�a/`s� License No. hh TYPE OF PERMIT ALJ GRADING ❑ F6UNDATI OO Nl it STRUCTURAL _ T Front DO -l'[s 7 _ �e se O
Address I IQ an Pt Cr r1c- O� C -(^r ❑ TENANT p ELECTRICAL PLUMBING XI MECHANICAL B' Rear - • N
Contractor's Name V K-v 1.1 �e-�I S Phone S'S ^VSt{
❑ OTHER s - A - r I
��l(1� to I PROJECT DESCRIPTION SQ. FT.5 C Right 1 ' N
Address(mailing) 7-t-L512 R�y� t�G ��-- Cc OCCUPANCYrryyX��� K C
�Spp CONSTRUCTION TYPE VALUATION$
1%4,�MI s Left '2Z •
City License No. n �� ZONE GRADING CU.YD5. ACRES R
LICENSED CONTRACTOR DECLARATION ppp �sr •
. Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 1 t _ 3' / ){ — S 7 Planning Notes: O Q
with section 7000) of Division 3 of the Business and Professions Code, and Y T con NI
Y T
my license is in full force and effect. ` ` 2. C\' ^—
License Class License No. ZL�� 1-` — S
Date .{Il 8 Signature r" PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
4s I hereby affirm that I have a certificate of consent t*lf-insure or a certificate ELECTRICAL FEES
N. of Workers' Compensation Insurance, or a certified copy thereof (Section I,_
Backflow Preventer Service Sink
3800, Lab.{C,. Automatic Washer Transformer 0 15-50 KW
as
/y
Policy No. sas0q 7 Company C01�TI&ekl—Ac Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW
Certified copy Is hereby furnished. CAS .
Cert l',fiecllcop� r)tIn clyiied with the city Buil Bathtubs Sewer Connection Cooking Unit Meter Clop to 100 amps
ate I— � Applicant_
EXEMPTION FROM WORKERS'COMPENSATION ARATION Clarifiers . . Solar Collectors Dishwasher Meter Clover 100 amps
(This section need not be completed if the permit Is for e hundred ($100)or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
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 Drinking Fountains Solar Tank Fan
Workers' Compensation Laws of California. � I Motors 00-1 HP 01%-8
Date Signature _ Floor Drains Swimming Pool vv/Spa - F.A.U.
NOTICE:If,after making this declaration,you should become subject to the - Inc.Solar 09-15 HP 016-154-
Workers'
16-15+Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal ,
comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave
CONSTRUCTION LENDING AGENCY Gas Service Outlets 'Water Closet I Device Boxes
I hereby affirm that there is a construction lending agency for the performance _ Pole Light
of the work forte �yhlth tNS permit is issued (Section 3097 Clv. C.) Interceptors Water Heatei Outlets Range
Lender's Name IV l Tt�f� i 9
• Lender's Address Kitchen Sink Water Service Switches Sign
OWNER BUILDER DECLARATION "
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash • Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or — P Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator
3enerator ❑0-5 KIN 05-15 KW
any structure, prior to its issuance, also requires the applicant for such permit �"'� coK' Trd5hC0 mpa¢tor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains �oL 6 {� 1 S —/s •
the Contractor's License Law (Chapter 9(commencing with Section 7000)of -R�1 `V 5�1y-+ 4
Division 3 of the Business and Professions Code) or that he/she is exempt — 1 I' l
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).
"�J I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3
'y-impensation, will do the work,and the structure is not intended or offered -
Reinspection Fee $15 Issue Fee $ 3
<o' r sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES
License Law 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 ownDEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 //''�� —�2
sale. if, however, the building or improvement is sold within one year of con- Canopy Type II ❑ Zoning Approved By Date
Diction, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Datf-==_-�'!I
shrove for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By goat
tractors to construct the project (Section 7044, Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100�TU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon, and who contracts for such projects with a conra
-
tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ em Repair/Alteration BUILDING PERMIT $ 0 SMTP $ e
proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ s PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ 6. 00 ISSUANCE $
Date Owner Heating System& Du ' Registers 111.1 PLAN CHECK 25% $ t 7,s,— ENERGY P.C. $
I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0100,000 BT • ELECTRICAL $ /�s Of3 GRADING $
information is correct. 1 agree to comply with all city and county ordinances
and state law elating to building construction, and hereby authorize repre- PLAN CHECK 50% $ �'� MICROFILM $
inspection
sentatives of chi I to enter upon the above-mentioned roperty for • , .., / �,.,/
inspection pur MECHANICAL $ TOTAL FEE $ ( 96•66
Signature • Date
Drivers' License or 55 ..3i Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ , f
CMF 086546,rev. 10/84 White - Building: Canary - Applicant; Pink - Accounting; Goldenrod - Assessor
'CONSTRUCTION AND PLANNINGPOOL &SPA
APPROVALS .Permit# .}Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location `/g?
Pti
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ///
3. Electrical Conduit Utility-Undrgrnd. 54. Forms It li ,
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
41:31,t VY'
5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test O e
6. Electrical UFER Grnd. 57. APPROVAL TO C ER-GUNITE (ory,7 b 14
7. Footings o ' 58. Electrical Cond ' -Undrgrnd. gg(( '/;_1' .0 d
8. Fpundation , - 59. Gas Pipe: drgrnd.,Test St N�.
9. Water Pipe-Undrgrnd. 60. Backv6ash Lines, P-Trap, 0 Undrgrnd. ! p 4
10. Structural Floor System (61. APPROVAL TO DECK ¶��1'} D4
•
11. Property Sewer Line & House Connection F2. Backwash & Receptor-Final . . �/5/8'/ 0 0 •
12. Sewer Cap63. Heater & Vent-Final
13. Roof Drains . - . 64. Plumbing System - Final 117h
14. Rough Plumbing' 65. Electrical-Final litaill7 D�
15. Rough Electrical-Conduit 66. Solar System-Final ((I
16. Rough Electric Wiring 67. Fencing & Access Approval /O/'J/ 7 Q�
17. Rough Wiring Sign )i; 68. APPROVED FOR PLASTERING of
�9 �'9 Da9`"
•18. Rough Electrical-T Bar Ceiling , I; 69. POOL/SPA SYSTEMS FINAL 1�,(I,.3/d'i nr
19. Rough Heating & Air Conditioning '7 � FIRE DEPT. REQUIREMENT - f
20. Rough Factory Fireplace APPROVALS Permit# -
21, Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil
23. Gas Pipe-Rough &Test ' 72. Underground Flush •
24. Roof Framing ;.. ' 73. Undergrnd.Storage Tank 0 Gas d Oil .
25. Roof Sheathing 74. Overhead Hydro -•; t>
26. T-Bar Ceiling (Structural) &''Monocoat 75. Dry Chemical f-.' . a
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 _ I-
31. Plaster Brown Coat 79. FINAL INSPECTION - • n _
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED - { V1
33. Final Electric Notes: r a'
34. Final Heating & Air Conditioning •
35. Final Gas Pipe-Test •
36. Hood or Canopy 4
37. Final Factory Fireplace t ,
38. Final Plumbing - .
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final 1.
42. Backflow Preventer
43. Backflow Irhgation '
44. Landscape Irrigation System • • 4 • -
45. Sound Attenuation . .t "
46. Handicap Regulations
•
47. FINAL STRUCTURE & BUILDING '
48. Special Requirements Completed • ' . ''
•
49. Electric Release to.Edison ' '+, ,_ w
50. Gas Release to Southern California Gas Co .• •
51. CERTIFICATE OF OCCUPANCY_ -'' -
No. ' Date ,. "••" ' v
i
1:.
Gunite j� ) Pos .2nsioned Concrete ( ) . NI-
REPORT OF INSPECTION ON Masonry ( ) Fireproofing
Concrete ( ) Reinforcing Steel ( )
' TO: Chck
Address :
OWNER: l (ayvgrin
PROJECT: SLyienri-‘103 �n � Krjq Report No.
Address : IeiQC4 NA IC COPermit No. (),e a`reera
Architect: 5.jv 1'r�� Contractor: 5w4q) ,/c
Address : Address :
Engineer : il]..C. RNOAtrli Subcontractor: \ ra„u
(Gunite) 77''
Address : Masonry or
�/I-_ Concrete)
Inspector: at}, ° 771 Address :
°a: 3l sr! FuIIelAUi nab-5
Mix Used:4.a )
Slump, inches :e-
Admixture :
Designed Strength, PSI :% bob
The following inspection was performed in acc.Drdance with the approved drawings :
Cu.Yds. No. of
DATES Placed Cyls. Remarks
8 3D =5 Seel _ !l ^� 4c fA S4ee( !.l-cnr�tir e)
t"sz�'v wl,:P r • Nol)(N4,45`��� e J m,c
J
CZ ,h-Oa Ocrkis -'•., �. , i a)
Copies of Reports to: ( Indicate which Bldg. Dept . E furnish address of any not listed)
I rtt PttLLINtU
.. 19 42 re- 2 1963
•
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT,
P.O.BOX 317 COSTA MESA,CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT i_oTIS ge BUILDING
BUILDING For Office Use Only
ADDRESS 1 985 73 a l a FI r I c %r.
RECEIPT NO. P�'7%yy
COSTA MESA, 'CALIFORNIA // } /! j
jfPr West .J ; + VPnIILY'G REC81V OBY DAT—/3-6
RECEIVED 3-63 MAR2B2DEtoc3
OWNER Pn oe sr D
%� /
BUILDING
MAIL ADDRESS
ADDRESS % (>S3 M j Y]O r G L b(- J
FIRE L
TEL ZONE TYPE GROUP J
CITY ( OS fA MPST_ NO.� r-/03H�
APPROVED
ARCHITECT (/ 1 TEL BY DATE
/)A
OR ENGINEER I ten fIZ cA- NO.77.).-36 I
ZONING _ t (�/
ADDRESS 9 7 9 pa to l l a - /4 net.h e i m '
1 C .
ZONE NO.OF UBE OF NE /
CONTRACTOR Andros )•-• n d l J , (/ / PLANS L. I BUILDING , ((v�1��'I�/,I`
/ wn
LEGAL 5' N7",7 6 I f 3 V ?
ADDRESS
� i 6 6 3 /"I I n O h ca Dr _ DESCRIPTION V V'� T rr CCJJ
CITY ( nsta Hes z A.P.NO. /C)
NOTE: NO EAV EOVERHANG SHALL SE LESS THAN
STATE TEL. 1.,/,
80" TO SIDE @ REAR P.L.
LIC.NO. /117 / 6iEAVNO. yO3�j 5—
SIZEALLOWEDIEB
OF LOT 7 7o° NO.O ON LO "� (U.B.C.REQUIREMENT)
NOW LOT".
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ' ACCESSORY BUILDING
EXISTING BLDG.
(FROM C//�^LL�3 STREET)
SETBACK LINE FROM •/ • 1 FRONT (JFT. FT.
CENTER OF STREET 5-3
REAR YARD 3)
SIDE YARD I LEFT AJ 1 I RIGHT q 1 R.SIDE 7 FT. FT.
DESCRIPTION OF WORK L.SIDE 7 FT. FT.
NEW � ALTERATION, ADDITION REAR31FT, FT.
DISTANCE BET. BET.MAIN a
REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.SLOGS.
BUILDING 4 NO.OF VAR.# DATE
SIZE a0 ftl ROOMS 7 STORIES la• C.U.P. APPROVED .+,
EXTERIOR WAL I ROOF APPRO E ( ( �7:f\{
COVERING ?t(Acc G COVERING otk r SAtka BY , DATE J
USE OF BUILDING AND WORK E PERFORMED
. -"e it de nee—• eB nS. / rue-Ti G Y)
3)_ A -,2iga.FTd- So
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY CEO AND STATE WS REGULATING VALUATION S-
BUILDING CONSTRUCT • _
SIGNATURE OF -�// -,/` r— PERMIT FEE $ �! j
PERMITTEE 1 .!l K. ((( -( -R-(C - +, 3 / ^ a
$ �07 �907- KKK/// 0
AUTHORIZED AGENT / TOTAL FEE $ / Y E
f 6
OWNER PACESETTER WEST JOINT VENTURE DATE 3-22-63
JOB ADDRESS 1984 Balearic Drive BUILDING PERMIT NO. 191142
GENERAL CONTRACTOR Andros Land Company VALUE $22,592.00 .
AP No. LOT 58 TRACT 448 FIRE ZONE DESCRIPTION OF WORK res att gar
INSPECTIONS Signature DATEDA ],
��GROUP I&J TYPE V ZONE R
Soil /.--:----ft- Yom- ' PERMITS ISSUED
Gas SUBCONTRACTOR DATE NUMBER
Water �- ?Les,-/2./r.--31—
Rough Corn. Refrig. 0 Air Cond. 0
Rough Heating /9 /fs 9- ?-L 2 X-.4-"' , n2,1h ,fir' -/�L-CS$ _65'Z —
Rough Plumbing Y. OJ. 9-5?-0X ao� ..L�� 41-.2- es
Miscellaneous / OOO L M�����°
Prop. Swr. Line.l� House Con.0 St. Swr. 0 ff/.nr 7_/e-43 �,Q/r/r/. �1 j cs./ 6 -/0?-63 3J '0?
Sprinkling System // c7
Construction Pole al
Underground 0 Power 0 ,/ I
Rough Wiring 77 7 .. .(;j wRua(A0' fl[ ..J JGu/ L-77�/3 '7.0/ •o --
Trenches Mfr 0.--- ter S'-- Forms Steel Rein6
Floor System - /M -- S-/—Ci3
Bond Beam 0 Steel Reinforce 0
Sheathing Krill e-21'-63
Frame and Flashing ]—teol 7-1l–(TJ —
Lathing — In r�� ____ L_ 2- lie-C41114-C411lie-C41114 / /5 e,
Plaster, brown coat 2-30-63
Refrig. -0 Air Con. 0 Final
Heating, Final S.QJ_ 41-/A 63
Plumbing Fixtures, Final . t Atire7
Final Gas Test WI?' �fJ
Electric Fixtures, Final //fre y _
Building, Final /1/_ _0,--/c-j T
OCCUPANCY . I
Form BU4-5M-313--S-B P