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HomeMy WebLinkAbout1242 BELFAST AVE - Building Permits r CITY OF COSTA MESA . os`"lift• BUILDING DIVISION F i'rn'�)2 • 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: B11-00153 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 14104112 DATE ISSUED: 05/11/2011 ISSUED BY: CAC JOB ADDRESS: 242!BELFASTYA� ,V M - Suite/Unit: Vicinity: - Squares: 0 - . - Valuation: - $4,000.00 SCOPE OF WORK: TEAR OFF WOOD SHAKE INSTA11 1/2"PLYWOOD • - • IF SLOPE BETWEEN 2:12-4:12 INSTALL 2-15 LB FELT IF SLOPE IS MORE THAN 4:12 INSTALL 1-15LB FELT.WITH MIN.CLASS A 25 YR COMP SHINGLES. - - NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and.carbon monoxide alarms by the City Inspector. See Attachment.w/Inspection Card 5TcghxcN . OWNER: f-k)L-L�f2, FRED - -• - Address: P O BOX 3313 ' Unit: PHONE: 951-760-8662 City/State/Zip: HUNTINGTON BEACH,CA : 1 .1.„.0'\ I52 APPLICANT: FULLER,FRED - - Address: P O BOX 3313 . Unit: : PHONE: 951-760-8662 City/State/Zip: HUNTINGTON BEACH, CA ' CONTRACTOR: OWNER-BUILDERLicense No. 000000 Address: Unit: _ PHONE: City/State/Zip: CELL: ARCHITECT: License No. PHONE: • ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 • : Reroof Permit Fee: $97.25 ,:ic 1 H.•-til (Med Reinspection Fee: $0.00 • Bldg Std Admin Fund $1.00 TOTAL FEES $98.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 u,;(: _ Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day •I: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.gulations. (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 N. INSPECTION TYPE DATE INITIALS CODE it INSPECTION TYPE DATE INITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical .1266 Pool Spa Final 208 Final Plumbing ... 200 Final Re-Roof )( —lig-11 ® 210 Final Electrical c7:irii 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 I n '} WORKERS'COMPENSATION DECLARATION: Own:Jedi -sa.,:• • drip... _license. in Yes ❑No /) 0, I hereby affirm under penalty of perjury one of the following declarations: Driver's Licen - No. Expires. /i1/ G� //,Z ❑ have and will maintain a certificate of consent to self-Insure for worke - ion of Ownership by(type of document,i.-. t .. y 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 DIVISION OP INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this 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: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp (This section need not be completed if the penal is valued at one hundred dollars(3100)or less) 2,Put 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ 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 the workers' compensation provisions of Section 3700 of Applicant's Signature Dale the Labor Code,I shall forthwith comply with these provisions. Division of Industrial Safety Permit Number: Applicant's Signature Date 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? ❑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 is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑ No Lic.# Class# (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 Contractor's Signature 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 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)? ❑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? ❑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, 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 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 ❑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 hndred 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 o ensation, 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 rir as o r of the prope y, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. �- EN ONTRACTORS o construct a project(Spc.7044,Business and if 'rofess' ode: The do tors Lic w doetiot apply to an owner of Signature Date .ropert who ilds or impr ves 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 authorizer!-by thi p-y", t'-final inspection. C.� I�/!i�.I /7 // �_ 40 _ 4--- ��L _,��_. < ' ign.lure of Legal Ow rflP 3057-46 Sal e Andlor Authorized Applicant Date • City of Costa Mesa [ding (Division Costa Mesa 77 Fair Drive, Costa Mesa, CA 92626 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION Permit # rBI — 00 53 Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been subagitted in your name listing yourselfas the builder of the • property improvements specified at /a V, / ""-/C5 -S' (c_5r4' friIet-Co9, (Sit- We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. t51.• I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any . injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. • 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibility. A53. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. GS 4. I understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. 761 5.• I understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer' under state and federal law. A31 6.• I understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 /5'8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. , 0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand •that I am the party legally and financially responsible for proposed construction activity at the following address: /g3.11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Signature of property owner �— Date:✓///,/>0 Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to a ply for, sign, and file th documents necessary to obtain an Owner-Builder Permit for my project. — Scope of Construction Project(or Descriptione� of Work): ��J�/a C E Q ��/�� �/ Project Location or Address: 4GC y1 /3.6/74-4,--$74 L- r©S/6Y " ` PSS Cif Name of Authorized Agent: / ��[ �/�z�G`� �✓/ Tel -No 95/- 760166'a?/ Address of Authorized Agentr�g82,1 Cdx./ e lir�"S Zl t / -&Melt/ ��,6> I declare under penalty of perjury that I am the property owner for the address listed above and I pe so>affy filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: ( ..7-1.1,47.27( ..7-1.1,47.27( ..7-1.1,47.27 Date: 05////// i 3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2 PRWECTADDRESS: 1242 BELFAST AV UNIT: - CITY OF COSTA MESA — BUILDING PERMIT - PERM NO: B 05241,4 OWNERS NAME: FULLER TRACY ANN • • ADDRESS: P U BOX 3313 ' PERMIT NO: B 052414PLAN CHECK NO: NGOVT: N SUPP : N • HUNTINGTON BEACH, CA 92647 - 1.fCONSTRUCTION TYPE: 5—N PERMIT TYPE: 5TR PURPOSE: ALT r ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF 2100SF RESID & GARAGE W/SHAKES SQ FT: ' 4., 500 ••X. ADDRESS: UNIT: • CLAIM VALUE; 4 , 500. 00 CALC—VALUE: 4, 500 . 00 GROUP OCC: R-3 /M-1 • PERMITTEE: ALL—COAST ROOFING ( 714 ) 650-2244 . • ADDRESS: 2107 WALLACE AV ' COMMENTS: TEAR OFF & REPLACE W/CLASS "C" SHAKES •• • C.M; CA 92627 *..Ex*-xxxxx*xx * r* T *sxT *x y�x kxx u ****x FiEx*� xxx **xx� p��J�i A��g�lpEF�;1��R ki LICENSED CONTRACTOR DECLARATION: I hereby affirm that am licensed under provisions of Chapter 9(commencing with Section ZONING R E Q U I R E M E N T S --'�� e+ n ." �� 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS • A I x..a Date uc.: 051929 4/44/_ uc.:�9 Signature: cuss: r(� / — tlp �Yg 15 li �— rt ' MAIN BUILDING • ACCESSORYt?:LN Dale: r. l/�'.ly ' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT' IN: WORKERS'COMPENATIDN CLARATION: I hereby affirm that I have a ce mate of consent to self-insure or a certificate of Workers' LEFT: FT - IN RGHT: . FT IN LEFT: . FT IN RC;HT: 'FT' IN Compensation Insurance,or a certified copy thereof(Section 3800,'Lab.C). , POLICY NO.: EXP.DATE: PARKING REQ: PROV: PARCEL : 42546204 ZNE; REF NO; "OMPANY: PLANNING NOTES> Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. I >, " ***********x-**3(�*************it************i(****i(** **ie*****K*******is**x ****a1'x Date: Applicant. DEOPMEN SERVICES R' E Q U I R' E N E N,T S EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). ._.. I certify that In the performance of the work for hich this permit issued,I shall not emplo y erson in any manner so as to become ' subject to the Wo ers'Compensation Laws f California. .1 ZONING APPROVED, B Y ' DATE; ., r (�/ Date: (p l"�'/q I Signature: BUILDING APPROVED BY : DATE: NOTICE:If, Der mala g this declaration,you should become subject[the Workers'Compensation provisions of the Labor --0, �1 G` / Code,U you must foNG comply Iwith ebysuch provisions that r this permit shall bedeemed revoked. APPLICATION IS'S,U ED B Y: J � DATE': 1 / CI t CONSTRUCTION permit LENDING AGENCY: 17,Civ.affirm that there is a construction lending agency for the performance of the work for ,*,***lE 1(if#i(iE 7e$E iF-x iE-x 3f****} *}F 1r***X*X****X-if ieaF,Sa 1F Of***k-*x*R#dF x if lE iE if 3�:3�x-Y::3F*ti#�lIFFF *k. . E k#x x. which this permit is issued(Section 3W7,Civ.C). LENDER: X***X***3f X****?E*36*k- X1f*iE*xRx•#*3fx-*1FX*XiF*-X*x*k3(.*****iExIt****3F*!f3'*x*±ii61Fk***li*)4.x1 **-1( ADDRESS: - LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC:'' MECHANIC FIRE SM:I P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 12 , 00 ;^ r,'" 1) ;r 50'/ •repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed _ 7 SM I P/NON—RES , pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN - a'''' f and Professions CodeFor 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). ISSUE FEE - in ,-, 0 BUILDING—DIV—> PERMIT ISSUE (FLAN—CHECK ' • TOTAL PAID / DUE I, as owner of the property' or my employees with wages as their sole compensation, wit do the work, and the TOTALS----> 72 . 50 50 .0 . 00 0., 00'' " 72 . 50 72 . 50 • . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors State License Law , d1i does not apply to an owner of a property who builds or Improves thereon,and who does such work himself/herself or through - •4— , his or her own employees,provided-that such improvements are not intended or offered for sale.If,however the building or 'REVENUE DIVISION TOTALS--> COLLECTED :„ :"' 72, 50 OVER/SHORT: 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC ; (FIRE SMIP/TOT GRADING PLAN—CHECK .. for the purpose of sale). 72 . 00 n d '' . 50 I,as`owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon .**********************************Nf***fE-7fXx-****,4*R***#3e*******aF*X********3F**+0X*x and who contracts for such projects cath a contractor(s)license pursuant to the Contractors'State License Law).I am aware y 1�i. - r that proof of their Worker's Compensaion insurance should be provided Co me. I ND I V I D U A L F, E -E E C R E A K D O W N • ❑ I am exempt under Section: B.&P.C. "1 t i"-J' for thisreahon: . TYPE QTY . D E S C R I P T I 6', N / ' `f n UNIT COST TOTAL COST •• • - .r 1. C1 ' Date: Owner: SFR 4500 REROOF BY VALUE RESID.ENIAL, NOZONE 1 . 00 . , :1 4,'500 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END.. OF FEES ' 25534 and that.'or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a • - It " C' , .,{1 • permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from t. (• •. , these provisions. 1 1; e"', / ,•••,+ • / • iI y. ^ / JJ/ Date: Applicant: +" �'Y ., ,` I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county , ,1, .. . ordinances and state laws relating to buildin construction and hereby authorize representatives of is •• to enter upon the above"mendoned I_ �'j property for inspect) n pu s. _ U( ` c /_ l//Ly/�c/yM' • Date: `� Signature: FATE: 6'o,'I3/91 Par; Ik:;1 1841-46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor r - " " 1 CONSTRUCTION AND PLANNING POOH -.'SPA Date Inspector Date Inspector APPROVALS Permit# _ APPROVALS Permit # - 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . , -, 2. Soil Pipe-Undrgrnd. • .- _ _ - 53. Steel Reinforcement • 3. Electrical Conduit Utility-UndPgrnd. _ 54. Forms 4. Electrical Conduit-Undrgrnd." 55. Electrical Bonding 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE . 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe,0 Undrgrnd.;Test ` 9. Water Pipe-Undrgrnd: • 60. Backwash Lines, P-Trap, 0 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 r 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing J/J� 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 6 /y(g� /' Y 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat K L 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric - . . Notes: 6-,'y_q,f- l rtc c-/ ei, � �� e 34. Final Heating& Air Conditioning 1141/4 9-e Vaca+,. r IC00 'IC • 35. Final Gas Pipe-Test ] iP__ r,c -WI- /AO kie st- roj4.9. 36. Hood or Canopy 4o w91 vt,� YI-, 37. Final Factory Fireplace a-O _ /_ � 0- -i. Y't-"/ - - 38. Final Plumbing QiYt'/ �"'C/�� 39. Water Service-Final ' ig 6.w 40. Gas Service-Final . 41. Solar Domestic-Final 42. Backflow Preventer ; . 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation• , 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING Z-gS 6L.,v/ ._ 2c.,,a4e Jr �4`�-, . L 48. FINAL PLANNING GIS (II��IY� 49. Electric Release to Edison 50. Gas Release to Southern`California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date ,._ C'�re'sa Building Department APPLICATION FOR PERMIT COSTA ME A,oCALIFORNIA x 317 4430 BUILDING FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. r ns 1242 Belfast Avenue , \ 4354 Costa Mesa, California Received by / Date Recd. Date Issued Nearest / `' 92 /-9--s-7 PER 1 n 1057 Cross St. Fairview & Baker Building • Address owner College Mesa Company • Mail Costa Mesa, California Address 1777 W. Lincoln Avenue Nearest City Tel Cross St. Anaheim No:Ke. 3-3161 Zone No.of I Type?", Grou Architect or Lia Plans V 0" Engineer Quigley & Clark No. 08884 Approved Address 1323 No. Broadway, Santa Ana by Date city Lia CORRECTIONS Contractor The Hale Company No 3422 • Address 1777 W. Lincoln Ave„ Anaheim Legal I I Block Lot I Description No. 153 I Trac&671 (Attach Metes and Bounds) No.of Bldgs.None Size of Lot 64 x 100 Now on Lot Use of I No.of I No.of m Existing Bldg. Families Rooms 5 - II Setback Line from 50' Rear Yard -iS; Z Center of Street Side Yard S y DESCRIPTION OF WORK r New I X I Alteration I I Addition I Repair I I Moving I I Demolish I W Building No.ofu Size 11.81 Rooms 5 Stories 1 Exterior Wall,, Roof — Covering Stucco Covering Shake APPROVALS I - Use of New Building Single familydwellingwith Foundation Location Inspector - Date g Forms,Materials, attached gara•e. Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application — and state that the above is correct and agree to comply Lath. Int.with all City Ordinances and State Laws regulating ; i building construction. Lath. Ext. Signature of / THE HALE COMPANY Permittee Plaster, Int. W Authartze f 4 . Plaster,Ext. Vl A Valuation Permit Fee $ 26.00 Masonry Reinforced Plan Check$ 13,00 1Bond Beam $ 10,248,00 Total 39,00 Fee $ FINAL FORM 204 1055 0.P.&5 , ' —1 • S" 0 • J c J o . a a .i • • .J.;n. r. Street • PLOT PLAN • Show location and distances from property line and between buildings. 4 4 I • Cil .O I-i' e. 0 • • ill ft/ IJ b • , , • • nr, •;I Sr. r OWNER COTS,FC,F MESA COMPANY DATE 2_ll1_57 JOB ADDRESS 1242 Belfast,Avenue BUILDING PERMIT NO. #4354 GENERAL CONTRACTOR The Hale Company VALUE $ 10,248.00 LOT 153 BLOCK TRACT 2671 Single res. Watt. gar. GROUP I & J TYPE V ZONE FIRE DISTRICT 4430 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench e -/Y--C7 Foundation Forms and Grade to Garag i 3 '.5-` r , Rough Framing . ` 3' - .- 7 Plumbing,Rough to Slab w :.°� � ;y .?..44. fi r Plumbing,Rough Complete •cp3 --a)-r7 -'� I Temporary Pole Wiring, Rough agent . - _ . ,-s 41/ 9y // Heating,Rough C 5 - -.17-3-7 �i7:1/W , /,t-it-cb 79 g,tI/ Heating,Final miss /D S7 pp -P— ,l Sewer, House6k Sewer,St./14,/S 7-J/57 9-.7 2 , 1�n e1 C: , ,. 7-11-57; 77.9Z Septic Tank or Cesspool mayc ,t y Lathing, Ind( Out}( & g-"7 Plastering 14414. ..raI`.4 Plumbing,Final,Fixtures Complete,494-S Cf-Id c 7 Plumbing, Final Gas Test/6"-__. A°S- ,�J� I\\Vlll t/it H., Wiring, Final . _)7 f �/ 'L.�`=e 'er is /i • Occupancy X7,7 q-10 -s j �` FORM 210 3M 10.55