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184 BROOKLINE LN - Building Permits
• ADDRESS OFBUILMO 184 BROOKLINE LN WIT: CITY OF COSTA MESA — BUILDING PERMIT moors NAME IF KNOWN: JEFFRTES, DON F PERM NO: B 072662 ADDRESS 184 BROOKLINE LN COSTA MESA,CA 92626 • PERMIT NO: B 072662 PLAN CHECK NO: N GOVT: N SUPP: N AfPL.MAILING ADDRESS: CONSTRUCTION TYPE: VN PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENGINEER: UC No.: JOB DESCRIPTION : T/OFF, SHEATH & REROOF W/COMP SHINGLES SQ FT: 2 , 924 ARCH.OR ENG.'S ADDRESS: WIT: CLAIM VALUE: 2 , 924 . 00 CALC—VALUE: 2, 924 . 00 GROUP OCC : R-3 / CONTRACTOR'S NAME: STOUT ROOFING INC ( 310 ) 923-6.775 CONTRACTORS MMUNG P 0 BOX 4309 COMMENTS : SMOKE DETECTORS REQUIRED PER 91 UBC ADDRESS: DOWNEY CA ucxo.: 402536 ****Res*+r***Rr*sr***sc***sE******>E*Bc*RrTE>E****RE*** ** **K***x-**x-**KiERE>E>E*BE*******>E>E****>E 90241 urn ZONING R E. Q U _T. R EMENTS UCENSED CONTRACTORS DECLARATION:I hereby affirm under penaly. ury that I am licensed under prodsions of Chapter 9 SETBAKS (commencing with Section 7000)of Didson 3 of the Business and Profes and my license Sin full force •••effect. CITY uc.NO.: 059377 uc.cuss C 39 uc. ' 02/:6 E 10 95, MAIN BUILDING ACCESSORY BUILDING CO Data: -z9—J=23 comaap A.IIL IJ 44' 'RNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ), . (Ci+oWN ER BUILDER DECLARATION:I hereby affirm under pe . d perjury that I am exempt from the Contractors Li•. -e Law lathe PARKING REQ: PROV: PARCEL: 41916467 ZNE: REF NO: following reason(Section 7031.5 Business eel Se Professions Code:Any city a county which requires a permit to most ,after.improve, demolish.or repair any structure,pier to its Simonet.also requires the applicant for such permit to file a signed statement thal he or she PLANNING NOTES> is licensed pursuant to the ode)Of d the she is xe License Law(Chapter 9(commencing with Section 7000)of Division 3 of the > Business and Professions Code)or that hep she is exempt therefrom and the basis e l the alleged exampin.Any violation of Section . 7031.5 by any applicant for apermit wMeds the applicant to a civil penalty d not more than five hundred dollars 155001). **************************!E*******************X**********************iF********* ❑ I.esowner of the property a my empIoyaes with wages as their sole oompensatian,will do the work,end the structure i not intended DEVELOPMENT SERVICES R E Q U I R E M E N .T S Of clewed for sale(Section 7044,Business and Professions Code:The Contractors License Law does not sporty to en owner of property who builds or improves thereon,and who does such work himself or herself or through he or her awn employees.provided that such f impmmonere vemeaarenet�ntendedorgforsale.f.however.thebuildingorimprovementSsold within dcompletion, ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not buiM or improve for the purpose of sale). O I,a caner of the property,am exdueivey c ntracting with limned contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not apply to an owner of propny who builds or improves thereon and who contracts for suds projects with a contractor(s)licensed pursuant to the Contractors License Law). / /� in B.AP.C..forthireason: APPLICATION ISSUED BY: DATE.: (/l ************************************* * * -************************���sc ***4EvvvEEE.JJJrrE** Date: o""" LEGALIZATION:N F E E SU MARY STRUCTURAL SEGMENT: Y I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533.and 25534i and dud I or any Mute building occupant will/will not(circle one)need lo comply with said stale codes end the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING a permit for construction or modification/TOM the Ar Qua lly7rarepemanI District.Residential construction appimtipears exempt from Mese provisions. PERMIT 59 , 00 SMTP/N. 50 ON—RES Date: Applicant: PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of pwjury one of the following daferafions: ISSUE FEE ❑//////��T111 have and will malntet a certificate d consent tosefimure for workers'compenstun,as Provided Mrby Section 37004 the Labor BUILDING—DIV—> PERMIT ISSUE. PLAN—CHECK TOTAL PATI) DUE Codes for the peromencedtho work for which this permit is issued. TOTALS----> 54 50 0 . 00 0 . 00 54 50 54 . 50 . 00 I have and wit maintain oro kers'compemeation insurance,m required by Section 3700 of the Labor Code,for the performance of the waw to which this permit is issued.My workers' aN�L insurance canter and policy number are: Carrier �irp lrnn EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 54 , 50 OVER/SHORT: 00 Policy Number: 04494U0004687 10/19/95 BLDG PMT PLUMBING ELECTRIC MECHANIC F:TRE SMIP/TOT GRADING PLAN—CHECK (This section need not he completed Inv.Penni(is A"one hundred dclars Rl.• or less.) 54 . 00 . 50 ❑ I eerily that in the performance of the work for which the permit S... I not employ arty person in C manner On.-to become con tothe sonsolken'compensation pesllho Labor oaM,latell qua if Idbecame . • to the y., ' *****************************************************i(*1(*********************** INDIVIDUALice F E E BREAKDOWN Date: --,-0—qs APO. : - A4,- 1,, _ '.1..Idm/i ' Warning:Fauns tosecure wn.,. orcompensation coverage la unlawful,and shag subject an employer to eros •snaffles and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil tinea up to one hundred thousand dollar*(3100,000),In addition to the costal compensation damages as • •vlead ler In sxtion3706ofMeLaborCodsintwnt,andattorney''/eea. SFR 2924 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2 , 924 , 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury Thal there is a construction lending agency for the END OF FEES performance of the work for which this Fermi is issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I cents that I have read the application end state that the above information is coned.I agree to copy with all ply and county ordinances and state laws relating 10 building construction end hereby authorize eeyresentat&es of this ply Io enter upon the ebove.mentoned property for inspedia,purposes. D NE BURFORD N 01 00183448-00183449 TUT 54,53 �js/�t �ZL��Gi�w..: .�. / _.../ 40 / DATE: 06/05/95 TRtE? 10:35 /) ignalurelBrm * er/Agent/Anko ee 1Co •• — (5151-46.WP) White-Building Si Safety;Green-File;Canary-Apptcent:Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING T ;_ JL & 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. I ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines;P-Trap, 0 Undrgrnd. • i 10. Structural Floor System 's. 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final f 12. Sewer Cap 63. Heater & Vent-Final I 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing7. 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,imStructure . - 70. Underground Hydro 22. Ducts, Ventilating71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test L 72. Underground Flush 24. Roof Framing '• - ' ' 73. Undergrnd.Storage Tank 0 Gas 0.00 25. Roof Sheathing • (0_/f Q� /'e_�!�t_ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat !! (( rv_' 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- t 4. . . ' 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 /..• _ 45. Sound Attenuation , 46. Handicap Regulations - ('- • • - - 47. FINAL STRUCTURE &BUILDING 1 r-/3-•3S a/,vpri 48. FINAL PLANNING . 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY - . No, Date - vC 1 - OWNER SAM VISTA A1fltDTN(; Ct7MPAMY i DATE 6- -64 JOB ADDRESS 184 Rrook1 ine Tane BUILDING PERMIT NO. 22203 GENERAL CONTRACTOR same VALUE $ 3 35.00 AP No. LOT 103 TRACT 516o FIRE ZONE DESCRIPTION OF WORK rtsaw/att gar INSPECTIONS Signature DAT GROUP I ,j TYPE V ZONE R3 Soil G,/l1 PERMITS ISSUED - Gas 7 SUBCONTRACTOR DATE NUMBER Water 4,.. .S . �_d Rough Com. Re i:. Q Cond. Q Rough Heating . di/di/2/67, d0 3 — Rough Plumbing ,�/ / /r'i'l� a A7 ,c -Lila/ : /' 1 - -/-(>I 3(10 Miscellaneous �/ / Ott Prop. Swr. Line Q House Con. arSt. Swr. Q /t-n re..)-/Jy 1/ ( (�. DEC 9 1963 Sprinkling System 7 Construction Pole - / lc kat Underground 0 Power 0 / ` Rough Wiring �e 9-2-7-Cif (7 7n P .tl�.' 77r9/&v 3'0 7 re - Trenches Q Forms 0 Steel Reinf. 0 st Bloorond System ga- / / g �GY ,t_,_ . Bond Beam 0 Steel Reinforce 0 ( / 6 t�/,�/ Sheathing 1Y] e ?— /7 /(ocf Frame and Flashing__ Lathing— In ly Out g/ 0- I_ 9-70 5 1 Plaster, brown coat % ?— 3//60 Refrig. 0 Air Con. 0 Final / / bFinal -d•ij3' i� //�/ ()))0f,61/7 if / 6 Plumbing Fixtures, Final / _� f_ {�f Final Gas Test /,f - ,__/,-2 ._f,-2 �� 41 Electric Fixtures, Final .i to• Building, Final / / frit'. OCCUPANCY / / g.-q-( Form BU4-5M-3-63--S-B P ..�.-.- rill, corn Al. REOUIREMEN Th FEE RECEIVED 29903 COSTA MESA BUILDING-SAFETY DEPARTMENT SAY 1 9ON P.O.BOX 317 COSTA MESA,CALIFORNIA FINANCE DEPT. CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING ��,/ t4-ns—_ For Office Use Only BUILDING 7 ADDRE59 RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA /f r,..,.%(Th USS. //��� RECEI BY D T R CANED/[ DIT'Ie9UC OWNER �,/ b b L ea 4,..5 am!! �/ JUN - 'flit MAIL 1/%b J 'c r - I ADI INS; ADDRESS //�� � ,./• ADDRESS �]` '`�- FIRE CITY I.r /7r // NE.7A'A.7I�,7 ZONE TYPE GROUP /� '�..J /��fj `"'��'`��V�jJ APPROVED OR ENARCHIGINEER e��Wlp.� NO. %Q Q BY DATE U V�'{ iZONING ADDRESS Vfl_1 4i*&G ,. 4'a ` ry//�� Z 6 I2 I N0.100 UBE OP Nfi /T , ISI W I PLANO�(/. BUILOI J GAL CONTRACTOR /' c V7A- � ADDRESS mot e/�{� , ' J DESCRIPTION / j l7 /�� (./d�la3 � ' / / . // A.P.NO. N-1 - J V �( CITY /� �y� /` /� 1 LIC..NO. f 7 2 922.— N9 g7/O'j NOTE:30'TO SIDE B REAR P.LNG SHALL B LESS THAN r OL CJI J/ a EAVES SIZE �J NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT) OF LOT /XO X ?O NOW ON LOT USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. °M} MAIN BUILDING ACCESSORY BUILDING r,J SROM C/LsSTREET) N\ SETBACK LINE FROM FRONT 'FT. FT. \ CENTER OF STREET REAR YARD BIDE YARD LEFT © I RIGHT (D R.SIDE 0 AT. FT. DESCRIPTION OF WORK L.SIDE 1) FT. FT. l) REAR I 1 FT. FT. NEW ALTERATION ADDITION GI DISTANCE BET. BET.MAIN& MAIN BLOCS. ACCESS.BLDGS. REPAIR _MOVING DEMOLISH�) _ BUILDING NO.OP N n VAR. DATE g SIZE e�0 X 31/43 ROOMS ,5 /S�TORIES ./ C.U. APPROVED a EXTERIOR Vcaj9 ti J ROOF /j' APP \�..� COVERING.3J�LJC.C,(D COVERIN 4J_4 BY A\ AN" DATE I� /�• r� USE OF BUILDING AND WORK TO BE PERFORMED/ �J C U _ 9 / 11?ta I HEREBY ACKNOWLE GE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE i AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL Ulfl RDINANCES AND STATE LAWS REGULATING VALUATION '/ _ m aC BUILDING CON�TRU N. y,/`�j N PERMITTEF O </ PERMIT FEE $ /`-' j Q _.t m CC S /� A C EC // �y/3O Ba AUTHORIZED A/ENT TOTAL FEE $ 47 I�Q n =