HomeMy WebLinkAbout954 CHEYENNE ST - Building Permits� � CITY OF COSTA MESA �
� " 9 BYILDING DIVISION
F�� 77 FAIR DRIVE. COSTA MESA. CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� � FOR INSPECTIONS CALL: (714) 754•5626
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PERMIT NUMBER: B09-00116
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 14172313 DATE ISSUED: 07/02/2009
ISSUED BY: RMD
JOB ADDRESS: 954 CHEYENNE ST CM 'Suite/Unit '<
Vicinity: HOUSE AND GARAGE ROOF
Squares: 30000 � - - � � ' - .�- Valuation:� � �$14,000.00
SCOPE OF WORK: TEAR OFF (E) ROOF NIATERIALS, INSTALL 2 LAYERS OF 30# FELT ON A 4:12 PITCHED ROOR AND REROOF
WITH UGHT WEIGHT TILE 5.7 # PER SQ QCC # ESR-1647) ON AN ATTACHED HOUSE AND GARAGE, APPROX �
30 SQUARES. REPAIR AND REPLACE�SHEATHING AS NEEDED. . -
OWNER: DANG, KHAI VAN , . - . Address: 954 CHEYENNE ST �, - . Unit:
PHONE: - � ' - City/State2ip: COSTA MESA, CA �- - -
APPLICANT: VAZQUEZ, VINCENT . �
PHONE: 949-812-2209 -
CONTRACTOR: PROFESSIONAC ROOFING
Address: 17431 TEACHERS AVEUnit: � .
City/State/Zip: IRVIN�,CA' � �- 92614
ARCHITECT: � .
ENGINEER: � .
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $237.25 �
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
TOTALFEES
$238.25
Address: 17431 TEACHERS AVE _ �, Unit:
City/Siate/Zip: IRVINE, CA - . � �
," , ' � � License No. � � 926316
PHONE: ' � 949-8'12-2209. ... .
. ' CELL:' �. � �
License No. � � � PHONE:
License No. � � -. PHONE:
4
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relatetl
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.
COOER. INSPECiIONTYPE OpTE INTI71AL5 COUE1 INSPEC7IONTVPE DATE INiITIpLS
7676 Fized System Final Fire Preven(ion 206 Final Mechanical
1266 Pool Spa Final ���_,���,�- 208 Final Plumbing
200 Final Re-Roof � 6�"� W 210 Final EleGtriwl
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fira place 220 Final Planning Approval
203 Final Sign 222 Final Si�e '
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARAT�
I hereby aHirm untler penalry ot perjury one of Ihe following declarations: .
❑ I have and will maintain a certifcate of consent to sel4lnsure for workers'
compensalion, as provided for by section 3700 of the Labor Cotle, (or the
performance of the vrork for which [his permit is issued.
❑ I have and will maintain workers' compensation insurance, as requiretl by
section 3700 of the Labor Code, for the pedormance of the work for which this
pertnit is issued. My workers' compensation Insurance carrier and policy
number are: `.
Carrler.�--.J�I�TF �UN fl
(inis sedon neetl no( b/e �ciompeteC nlne peimrt is valaetl at one hundmd dol�ars (St00) orless )
POiic�ber:ti f "I I %�S� —G �
❑ I certi(y that in the performance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the woBers' compensation laws o( Califomia, antl agree that if I should
become subject to the workers' compensation provisions of Section 3700 ot
the La otle, I shall fortbwith comply with these provisions.
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A�ImenPs Signa�ure � _Q �3 ey.....
---�iu,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATfORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm lhat I am licensetl under provisions o( Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Protessions Code, and
my license is in full force and effect. �7 /
Lic�#""" " � ss,#, � ` lJ��
' . . . . fZC'C.i m' � - � �' S
�EONractor's S1gnaWre 'De�e�
a;.
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that Ihere is a construclion lending agency for the
peAormance of the wurk (« which this permit is issued. (Sec. 30W. Civil Code).
Lender's Name:
Lender's Address:
�ate
OW NER-BUILDER DECLARATIONS:
I hereby affrm Ihat under penal�y of perjury that I am EXEMPT FROM THE
CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Pmfessions Code: Any city or county which requires a permit to
consiruct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to fle a signed statement
tha[ he or she is licensed pursuant to lhe provisions of the Contrac[ors
License Law (Chapler 9(commencing with Section 7000) of Division 3 of Ihe
Business and Professions Code) or thal he or she is exempt lherefrom and
the basis for Ihe alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more Ihan
fve hundretl dollars ($500).):
❑ I, as owner of [he property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the strucWre is not intended or
ottered 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, antl who does such vrork 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 wiihin 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 ovmer of Ihe property, am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CONTRAC70R5 to construcl the project (Sec. 7044, Business and
Professions Code: The contractors License Law dces noi apply to an ovmer of
pmperty who builds or improves thereon, and who contracts for such project wilh
a contracta(s) license pursuant to the Contractors License Lavrs.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
305]-a6�]/0])
Owner ID verified by�ense. ❑ Yes ❑ No
�
Dnver's License No. Expires:
Verification of Ownership by (type of document, i.e. - property [ax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certRy [hat no excavalion fve (5) or more feet in depth into wfiich a
person is required to descend, vnll be made in connection wi[h work authorized
by this pertnit, and that no building strucWre, scaffolding, (alsework, a demolilion
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Ttle 8, Califomia Atlminist2tive Code).
❑ As ovmer-builder, I will not employ anyone ro do work which would
require a pertnit from the Division of Industrial Safety, as noted ahove, unless
such person has a permit to do such work from the division.
Appliwn(5 SignaWre
Division of Industrial Safety Permit Number _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuWre buildinq occupant need to fle and
certify a Business Plan for emergency response to release or threalened
release o� a hazardous material? ❑ Yes ❑ No
(Seclion 25505 of [he California Heal[h and Sa(ety Cotle requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has al any one time during a reportetl
year a quantity of hazardous materials equal to or greater than a vreight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
al standard lemperature and pressure).
2. Does or will the applicant or preseN or Wture building occupant need to file
a regis[ra[ion fortn for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Calitomia Health and Safety Code, wilh some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity o( acu[ely
hazartlous matenals equal lo or grealer than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic (eet o( compressed gas at standartl
tempereture antl pressure).
3. Does or will the applicant or present or future builtling occupam need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 ot the California Health and Satety Code provides that the
Costa Mesa Fire Department may require Ihe preparation, certification and
fling wilh [he Fire Department ot an RMPP by businesses which are required
lo register acu[ety hazardous materials with ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied wi[h? ❑ Yes ❑ No
5. Does or will Ihe applicaM or present or fuWre building occupanl require for
the work which is the subject of this application a permit for such conshuction
or modi(cation fmm Ihe South Coast Air Quality Management District or (rom
any other air polWtion control district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires tha[ the requested
infortnation be fumished on applications for non-residential building pertnits�.
6. Will any part of the facility to be constructed under ihis permit be wilhin
1000 feet /rom the outer bountlaries o( a school? � Yes ❑ No
Qf'yes", Ihe faciliry must meet the requirement of Sections 25534 and 42303
of the Cali(ornia Health and Safery Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control disUict or agency is required for the work which is Ihe
subject of this application, have all of the disclosures prescribed hy Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certificate ot compliance from the appmpriate air pollution
control oKcer).
�CERTIFICATE OF COMPLIANCE: I certify that under penafly of perjury the
information given above is correct I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury thal I have read this application and state that
the'information given. is correcL I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Ihe Ciry 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 Mal inspection.
�iqnaWreo(LegalOwne�r ) Dale
%lr.�Gy1_� �/.�'��Z % d�
Aamrnwnd,zea �' `=�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 954 CHEYENNE ST
Suite No
Vicinity:
Parcel Nunmber: 14172313
Applicant: SZABO, KEVIN
�
Address: 17390MTCLIFFWOOD-�. �
i .
FOUNTAIN VALLEY
i
�. � � : ,
, .��"
Owrier.'�'�DANG, KHAI VAN _
Address �,954CHEYENNE�SL
.. � " COSTA MESA, CA
PLUMBING PERMIT
t Phone: (714)241-141'4' ,
_ Zip: 92708 ' � , .
Phone:
Zip: 92626
Contractoc COAST ROOTER PLUMBING HTG 8 A/C
Address: , 17390 MT CLIFPN100D ;;, , � "� � � - •
,'-. FOUNTAIN VALLEY
Phone: (714)24�-1414
Zip: 92708
License: 529127
' Status: ISSUED
Applied: 08/O6/2004
Issued: 08/06/2004
ISSUED BY: �
Arch / Eng�: r- . -. , .� -f .. � _�, -,,-. - _- ^ - . . .
dd_ . � . _,. . �_._ _ r.._ . _
� A ress: . . _ ._ � � � ' �
. . ,
� � � - Phone:
. " - ., �. . ZiP: , . , � �. . , .
' ' � - - - - - - License:, . - _ • � � . , ' �
, , � , u - - .. . - .- ,. � /'.': , , .
' ` � SCOPE OF PERMIT � � '' � � � ' ' `
�i; � '.� l
" � WATER HEATER�CHANGE OUT. _ � . f, � .�
,. � , ,-' . _ ' :/'; . .� : ' ;
, � ���_� .:FEE,SUMMARY � !"' � �
:, . �_ �. %i . i, �`
� � AMT- . � . =iy�'�i - 'AMT-.:�QTY . ,//� �AMT
� ISSUE FEE ., , • � 523.50� ' . .LaLntlry Tub / Washer $0.00 �` 0- �� � _� ,,; �._Sump Pump � � � � $0.00
BackFlow irrigetion � $0.00 � 0 �-� Landscape,lrrigalion � " $0.00 � -� 0 �`' "' � � _� Swimming Pool ���� � � �� $0.00
BackFlow Preventer, $0.00 0 - '. P-Trap � _ �; � � - ,. $0.00 0 - Trap"Primer � � � �$0.00
Balhtub '��- � .; $0.00. , 0 ., "Pressure Regulator,��> ; $0.00 � 0 ,- Urinal j i�j , ��' � $0.00
ClarifierSystem����� '$0.00'1 0 �;�Process-Piping(per.,l0k)� $0.00 0 �� Vacuum�BrkFBkFlovr(1';4) $0.00
Connect (Ice,Soda,etc);� _�$0.00 �0 - � Rec`eptors,����� _<� _ $0.00 =` 0 '- � i Vecuurti Brkr Bkflo�i%(5+) $0.00
Dental Units ` �, $0.00 ; - 0 �. Septic Tank- - � $0:00�: �� 0 �V�Wash Basin/�� $0.00
Dishwasher �\$0.00 0 � �i f �� - Sewer Cap for Demo - $0.00 .0" � � \ Wash Basin Set $0.00
Drain, Floor $0.00 �. 0 � - , .Sewer Connect - , � � $0.00,- �,0'� �', `�, `- VJaste and,Vent System $0.00
Drain, Rainwater $0.00 �- �0- ' . Sewer Private Line - ' $0.00 - �0 ��' � ,,Watei Closet (Toilet) $0.00
Drain, Roof $0.00 � --0� ; _ Sfiower.,, - � $0.00 �_ . 0' ! r>Water Heater / vent $12.30
Drinking Foun[ain $0.00 0 � _ Sink, bar � � � $0.00 . 0 � -jGf `.%Water Piping (Inst or Rep.) $0.00
Expansion Tank $0.00 0 '" � � Sink; commercial � � $0.00 < 0 -' Water Re-pipe $0.00
Gas Earthquake Valve $0.00 0 Sink;-Floor._; �� _' �" �$0.00 �0 Water Service $0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0 ,
0
INOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related
'��. regulations. (Ord. No. 92-28, § 1, 12-21-92)
IEXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or it 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 '�
Irequired Inapeations and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permiL '
FOR INSPECTIONS CALL: (714) 7545626 i
zaas-as (e�oo�
WORKERS' COMPENSATION DECLARATION: ' � • �� �� ' � � � � � �
I hereby aflirm under penalry of perjury one oi ihe following declaratlons: • . � . ' -
❑ I �eve antl will mainlain a certificete of consent ro seN-Insure for workers' compensetion, es pmvitlad for by sectlon 3700 of the Lebor Code, for Ihe performenCe ot ihe
work for w�ich this pertnit is issued.
I have antl will maintain workers' compensation insurance, as required by section 3700 of Ihe Lebor Cotle, For Iha peAortnance of Ihe work for which this permit is issued.
y workers' compensatlon Insurance carner and policy number ere:
Carrier: Policy Number:
(This section need nat be comp/efed il the permlt is velued af one hundred dollars ($100) or less.)
❑ I certity ihat in the pertoy�ance of �he w�Ic br which Ihis permit is issued, I shall not employ eny person in any mennar so as b come subject to tha workers'
compensation laws I(�litomia, d ag Be Ihat It I shoulC become sublect to the workers' compensation provislons oi Section 00 oi ihe abor Cotle I ahell forthwith
wmply with Ihese pr �ions. � �
Applicant Signeture: Dete:
WARNINO: FAILURE TO SECURE W RKER OMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINA� P ilES AN GVIL FINE UP TOONE MUNDRED
TYIOUSANDOOLLARE(E100,000),IN DDITIONTOTHECOSTOFCpAPEN5ATI0N,�AMAGESASPROVIDEDFORINSECTION3]O60FTMELABOHCOOE,IMEREST,ANO ORNE1"SFEES.
LICENSED CONTHACTORS DECLARATION:
I hereby aflirm ihat I am licensed under pr ' ion of Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions C , and my license is in full
force and eXect. Lic. k Class k
Cantrector's Signawre: Deta:
CONSTRUC710N LENDING AGENCY:
❑ I hereby aHirtn that Ihere is e consiruction lentling agency for the peAormance oi ihe work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lentler's AtlGress:
Signature:
Date:
OWNER-BUILDER DECLARA710NS:
1 hereby ettirm thet under penelty obperjury ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or county which requires e permit to consiruct, alter, Improve, demolish, or repeir any siructure, prior to its issuance, elso requires ihe appllcant for such permit
to flle e signetl statemem Ihat he or she Is Iicensed pursuant to Ihe Omvisions of Ihe Contractors License Lew (Chepter 9(commencing with Section 7000) of Dlvislon 3 of the
Business and Professions Code) or ihet he or she Is exempt iherefrom entl �he basis for ihe alleged exemption. Any violation o� Section 7031.5 by any applicant for e pertnit
suh�ects the applicent to a civil penelty of not more Ihan five hundretl tlollers ($500).):
❑ I, as owner of Ihe property, or my employees with wages as Iheir sole compensatlon, WILL DO THE WORK, and the siructura Is not intentletl or oftered lor sale (Sec.
7044, Business and Professions Code: The Coniractors License Law tices not apply to en owner of properry who builds or improves Ihereon, antl who does such work
himself or hereelt or ihrough his or her own employees, provided ihat such improvemenis ere not intended or oNered for sale. If, hawever, ihe building or improvement is
sold within one year of completion, the owner-builder will have the bwden of proving that he or she did not builtl or improve for purpose of sele.). '
❑ I, es owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Protessions
Code: The coniractors Llcense Law tloes not apply to an owner oi property who builtls or Improves thereon, and who coniracts tor such project with a conVactor(s)
license pursuant to ihe Contractors Licensa Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID venfietl by dnver's license. ❑ Ves ❑ No Drivers License No.
Veritication af Ownership by (type of tlocument, i.e. - property tax 6iil or tleed):
DIVISION OF INUUS7RIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I hereby cenify that no excavation five (5) or more feet in depth Into which e person Is raquired to descend, will be made in connection wiM work authonzed by ihis
permit, and that no building siructure, scaHolding, falsework, or demolition or dismantling Ihereof, will be more ihan Ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle e, Califomia Administrative Code).
❑ As owner-bullder, I will not employ anyone to do work which would require e permit from the Division oi Intlusirial Safery, es noted ebove, unless such person has a
parmit to do such work trom the division. -
Signeture: Da[e:
Division of Industnal Safery Pertnit Number.
COOE I. INSVECTIONTVPE
1616 Fixed System Final Fire Preventlon
1266 Pool Spa Final
200 Final Re-Root
201 Final 81ock/Rateining Wall
202 Final Factory Fira Place
203 Final Sign
204 Final Demolition
UATE
INTRIALS
�
50�E I INSVECTION TYPE
206 Final Methanical
20B Final Plum6ing
210 Final Elecirical
212 Final Flre Prevention
220 Final Planning Approval
222 Final Sita
250 Final Building/Occupancy
Q� ItIDL45
�
Z`� � nccro,�t �o rn �� au
; 'Y COS7A MESA CONSTRUCTION PERMIT
� q��- C e�,tev�h�. '
Project Address
Applicant's Mailin9 Address ! �nh'+�� � �
Owner'sName KJJA-1 -�'A-•1J �T Phone �%
Address � n-� � %� � � �� Q--
Arch/Eng. '—"�� � License No.
Address �
Contrectoi's Name Phone �
Addresslmailingl � -
City License No. �
LICENSED CONTRACTOR DECLARATION- . ' '
1 M1ereby affirm that I am licensetl untler provi5ion5 of Charter 9(commencing
with section 7000) of DiviSion 3 ot the Business antl Professions Code, antl
my license is in full forte antl effect. - _
License Class License No.
Date• Signature '
IORKERS'COMPENSATION DECLARATION
he�eby aftirm that I M1ave a certifitate o( consen[ to selt-insu�e or a certifiCate
of Workers' Compensation InSurance, or a certi(ietl copy Shereof (Settion
3800, Lab; CJ; � �
Policy No. � ' Company � �
8 Certifietl copy Is hereby furnishetl. , i
Cer[ifietl copy Is filetl with the tity Builtling Divlsion.
Date' Applicant �
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Tnissectlon neetl not be completetl if tha permi[ is for one huntlretl (§300) or
less).
1 certity tM1at in the pe�/o�mance of the wo�k (o� wltich this perm�t is i55uetl, I
shall not employ any p¢r5on in any manner so as to become subject to the
� Workers' Compensation' l2ws of Califomia. ' .
Date - 1` Si9nature � • -
' NOTICE: If; after�making� [his tletlaration, you shoultl become suGject to lhe -
�. Worker5' COmpensationa provisionsbt the Lzbor Cotle, you must torthwith
compty with such ,proWsions or Ihis. permit shall be tleemetl revoketl.
CONSTi3UCTION LENDING AGENCV '
I nereby aHirm that tlieie IS a cbnstruction lentling agency for�the oerformance
of tfie wbrk for �wMCM1I thls permlt is issuetl� (Settion 3097 Civ. C.)
Lentler'S Name �
LenOer'sAdtlress - -='�-- -- -
OWNER BUILDER DECLARATION � I �
I hereby aftirm thaL'Pam-ezempt from the Contractor's License Law for the
following reason (Secti6n ]031.5 Business antl Professional Cotle: Any city or
� county which requires.a permit to con5truct, alter,'iTp/ove, tlemolish or �epal�
any structure, prior to itrissuance; also requires the applicant for such-permit
�o fiie a siqnetl.statement that he/she is licensetl pursuant fo the provisions of
ie Contractor's LiCenS¢ Law (Chapter 9(commencing with Section 7000) of
�I
�ro�s�on 3 of the Business antl Profe55ions Cotle) o� that Ite/she Is exempt
heretrom antl the basis for N¢ alleqetl exemption. Any violation of 5¢ction
�]031.5 by any applicant for a permlt subjects the applicant to ,a civil
� enalty of not more than five huntlretl tlollars (5500).
� I, as'owner of the �property or my employees witn wa9es as their sole
comoensation, wiil tlo the work, antl the structure is not intentled or ofteretl
� for sale (Settiom 7044, Business antl Profe55ional Cotle: The Gont�acto�'S
� License Law tloes not apply to an owne� of a property who builtl5 or improv¢5
'thereon, antl who tloes such work•himself/herself,or through his or her own
employees, provitletl that such improvements are mt intentletl or offered Por
sale. If; howeveq thE bulltlinq'or imp�ovement i5 Soltl within one y¢ar at com-
�oletion, fhe owner will nave tne burtlen of provinq he/sM1e tlitl not builtl or im-
p�ova tor the putpose of sale). � ' �
❑ I, as owne� of tM1e property, am exclusively mnt�acting wi[M1 licensetl con-
tractorsto conshuct ihe projeci (Section 7044, Business antl Professions Cotle:
ezceD< those within heavy_Doraer lines ana sign all
� �T�
�. .
' , R
� j
TYPEOFCONSTRUCTION LJNEW.IJAOO LJ'ALTERATION�\�J pEPAIR�
.❑ CONVERSION � ❑ DEMOLISH O OTHER _ ^ � � ~ � A P #
,DESCRIP,TION OF WORK/USE OF BLDG. ' `
, , ' , , � '� � S Main Bu
TVPE OF PERMIT GRADING 'FOUNDATION � STRUCTURAL � E
T Front �
;❑ TENANT ❑ EIECTRICAL ❑ PLUMBING ❑ MECHANICAL .,� B Reaf
❑OTHER_� " .' _ _ '' _" .' _'�� %�'
PROJECT DESCRIPTION'. 5(?. F7. � pCCUaANcv �ti' } C Right �
K
CONSTRUCTIONTVPET�i�___ VALVATION$ g Left �
'ZONE GRADING CU.YDS. ACRE ' `''ping. Ref. #
Remarks: � — ' ... Planning No'
, , ; � .
' „ , PWMBING . . , , �FEES '
Sink
<flow Preventer
. i_' ,
Clarifiers � � _
Dishwasher� '
Drinking Fountains
Floor Drains' .
Floor Sinks '
Gas Service ,
Interceptors
Kitchen Sink
Lavatories �
P-Trap '
Reinspection �Fee
Boiler :
Duct- Under,Ground
Duct � Structural �
a
'Sewer Cap � . •
Sewer Connection � � .
Solar Collectors ' '
Solar P.ipin9_ �
SolarTank;. ' '
Swimming Pool w/Spa
ets ;!Water Closet �
� � ,Water Heater �
.Water Service-� - --
%" �Aum-Wash '
� � � Laundry Trays
r/' .
$15 . '• Issue Fea �
The Contracto� s�Lmense Law tloes not appry to an� owner of property who , OUct - Ventil2ti�g !
' builtls or improves thereon, and who contracts for such projects,with a con-
tractor(5) license pursuant to tbe Contracto�'s License Law). I am aware that� ' Exhaust $yStCm �� MWLipIE ❑
' proof of tbeir Worker'S Compensation in5uranCe zhoultl be provltletl to me.
❑ I'am eaempt under Section' B. & P. C. for this reason - -- Firepl/Fact. Blt. ICBO #
Date, � � owner� Heating System &�Ducting �
I hereby certify that I. have reaa this application and state that [ne'atiove - '. ❑0.100,000 BTU Ot00,0006TL
• informa[ion iz correct. I a9ree to comply with all city antl county ortlinances -
antl state laws relating to bulltling wnstructiop , anG hereby authoNze'repre- _ • .
sentatives o! this city_�to enter upon .t e�'ab ve- entionetl' property for -�' - • � ' �
.inSpeCtion purposes.,/J / J�!/ � � � '
Siqnature � � ���b i-i.L�• .
Driveis' ��icense ar 55 � . -- ,
� Reinspection Fee $15 '
CMF 0865-46, rev. ]0/84 White - Builtling; Canary
nt; Pink - Accountin9; Goltlenrotl - Assessor
Hood�or Typel ❑ �
` Canopy Type I I ❑ '
� Refngeration System �
❑0-100,0008TU ❑100,000
System Repair/Alteration; �
� Fire Dampers . �
Registers �
Issue Fae
iTU
_I
�
� ' ' ` . Automatic Washer �,
' Construction Pole S
Cooking Unit- �
- ' Dishwasher ' ' �
Dryers ❑Gas ❑E
Fan �
1052 f2%p8/87 :. i 64,Q3 .TL
� : ! ;
�
_ Zone - � �-"
'Accessory Buildin9:� � '
0
a
� Z
` O
N
I
N
G
�
R
E
n
i• ' M
� T
S_
' , -. ELECTRICAL' :' ' �
�Transformer.��15-50KW '
�b. ' . ❑.50+iKW �
- ' Meter � ❑up to 100 amps �
. _Meter ❑over 100'amps '
lec[fiC � . 'Suh Panel . . ' -
Motors �41 HP 01 f
Inc.Solar_�9-15 HP [
Microwave' . �
� � DeviceBoxes � . Pole�Light � ' ' '
' Outlets � �� • R�ang`e '
� Switches - Sign � ' � �
� Garbage Disposal ' Standing Sections ' �
Generator �0-5 KW �5-15 KW Tiash Compactor ' ,
M�
$ 3
.
Reinspection Fee $15 luue Fee . �' '$ 3
DEVELOPMENTSERVICESREQUIREMENTS: ' `.
Zoniri9 APProved BY . � � . , . Date 1`Z- - . '.
Building Approved Bv �� d , Date
Applicaiion luued By Date
" � ' ' - SU ARV OF FEES � � � '
" BUILDING PERMIT $ ��'� SMIP :. $ - � '�, �'i7
' � PLAN�CHECK ' $� �-�-03 PERMIT � - -
� PLUMBING �$ ' ISSUANCE � $ � ' �
. _ , P.LAN CHECK 25%� $ - � ENERGV P.Q: $ . ,
' - ELECTRICAL � $ � - � �GRADING . $
� PLANCNECK 50% $ •;MICROFILM $ �/�-�_�/�.q
• MECHANICAL $ . TOTAL FEE . $ � '!�
PLAN CHECK 25% $ • � '
CONSTRUCTION AND PLANNING • � POOL & SPA , �
APPROVALS Permit# ' Date Inspector� � APPROVALS Permit# Date� Inspector
t
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 UFER Grnd. ` � 57. APPROVAL TO COVER-GUNITE . �
7. Footings � � , . � s✓ � - 58. Electrical Conduit-Undrgrnd.� ' � ,
8. Foundation � • _ 59.- Gas Pipe, O Undrgrnd., Test � '
�
9. Water Pipe�Und�grnd. • . _ 60. Backwash Lines, P-Trep, � Uniirgrnd. ' "
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 Eleccrical-Conduit , ' ' ' . 66. Solar SYstem-Final �'
16. Rough Electric Wiring -� ' -� 67. Fencing & Access Approval� �' -
17. Rough Wiring Sign - - � � - - 68. APPROVED FOR PLASTER WG' •- . � � �
�18.�Rough�Electrical-TBar'Ceiling � - � �69. POOUSPASYSTEM$�FINAL `,� 5 ��
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT �•' ^���_ ` � � rr
20. Rough Factory Fireplace ' � APPROVALS � Peimit # • _ �; "�
21. Ducts, in Structure � ' ' .' � -
70. Underground Hydro .
22! Ducts, Ventilating_ � � 71. Product Piping OGa; OOiI
23. Gas Pipe-Rough & Test , , � � • 72. Underground Flush � ; � �
24. Roof Framing '�'' '� � � 73. Undergrnd. Storage Tank O Gas ❑ 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 DEP.,T. REQUIREMENT
31. Plaster Brown Coat . � 79. FINAL INSPECTION - - •
�32. Electriral Power�Meter-Final - � . � �80. FOOD�CERTIFICATE ISSUED , >•' '
33. Final Electric i � � 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. $olar pomesticFinal- . � � , �
42. Backflow Preventer � - . � - .
43. Backflow Irrigation� _ � - - _ � � ' � �
44. Landscape Irrigation System . , � , ti�
45. Sound Attenuation � � - � � _
46. Handicap Regulations � � � � � , . � ' ,
47. FINALSTRUCTURE & BUILDING 1 Z` � , , .�
48. Special Requirements Completed • _ - . �
'.49: Electric Release to Edison . � ' - ,
< .
50. Gas Release to Southern Califomia Gas Co . � . . � �
51. CERTIFICATE OF OCCUPANCY , - , ��
No.' Date � � � � � � � ' '
/� 8189
k��AVO����� to flll in all.spaces azeep! t�ose wit�in �eary Oortler Iims antl slgn all apGroonata Caelant�onz.
— --_ ,.___ ._•- ,--__ _ - T- •-- ... .. . .
��'ITK.$F COSTA MESA1 � . I ; _. ' ... i - � �. PER IT• _rt0 . .TRACT NO ..� LOT NO.._ �' B � D' .-' � � ' ' 1 ' _� � ^� � - � - t � �I' y ��,
.. . _. ..� ' .
�� CONSTRUCTION P.ERMIT: I ''. , � : � �} � � �" , .. � , - � j i S ; , "� ' ,. .�� ' ; } , ' � , ' � ' _ i i � ..; , . .�: � � 1 Y> . , ._ r. ,
� AppllCent 5 Melling Addf2ss . TA.�. b� . � �.0 C Y, TypE•OF CONSTRUCTION � � , NEW � _ ADD � ALTERATION" ' REPAIR -_ � � ' I . ! � � � � .r r � ] '. r �
� a � . � �y/ �- � t :• ; 1 - , e : ' ' � ` ' n , . .c ' � , `�� . . . � j . � I
> . P�oject,Addreu���%��'�'E.wG OS'A/J/�A ❑ CONVERSION ;O DEMOLI$�i ��O7�-�ER ' • � = � ' ' .-o'I CTA �tin L �
� �v1 ��� . ;• iLo !n- ,fSLdC.EKLr/AC< �T
�'/�liP*IL%GbG"•` - - � �Phone � ,.DESCRIPTIONOFWORK _ _ L
Owner s Name . � '4C�� I ' . .� : � .�_ . � _ , . . i �.,, � , ... � � � �o : . -: 1 , ; ING E U 'ATI N - - ' . . • �. _T �
', 4SS�G�HErrN/�F C�ccTA/I%SA= `' i ; � . - . _ - `- , . , 2 ,
ddfe55 r, , , ' , ` T ', . TYpEOFPERMIT � --fGRADING� FOUNDATION STRUCTURAL �9 � A.P'#°I ` vZ,:l F 3 � ZONE' ' + i - C, _ + � , �
� 1
�'� ArCh/Eng __ ; T` , LiCensO No - J ' � ❑ TENANT O ELECTRICAL . PLUMBING ❑'MECHANICAL � � ^� � � ', _ i ;-, �'BUI�DING� 'i _ I • - .
� . � - , . , ' . , ` . �PLNG. REF..'kt ._ . � . � •
AddfE55� ' � " � � 0�' OTNER � �� �-� i � I ' � TO BUILDING � � � '
� • - �' , �, , . I � . t ' � ' � � - - i PR ER V WE ; . eflEAR YARD (TO P/U i _ >
n rector s Nam /f hone �STi49.2o/ 2 ` PROJECT DESCRIPTION � sQ F7.' 'l � ''OCCUPAN v . � '
� Addi ImnlnnllORAISGATCR uE�%0�4-oN//1A/.�U/acGOY� _ , CONSTRUCTIONT.YPE � ' ' � � �.VALUATION$� LEPTSIDEVARD � i RIGHT�SIDEVARD- � �' � / �
t �. � � ( i ! • 1 P.KG.SPACE�REQ. � . PROVIDED t
� '- �Z�c�a�'.3� +�" i =- . ZON€ ' ' GRADINGCU.VDS. ,ACRFS � � 1 «
i Gcense No. � . . - � _ ..n � , , , � • I . . • ' �
� LICENSED CONTRACTOR DECLARATION , ' t [t 1 ; , � A Remarks: � ; ; � � � � .i � � � , � � "� � STREET WIDTH , { ' � . PARK FEE $ � ; -� -; ,
f6hereby afflrm that'I.am Iicensetl untler proNslons o1�Charter�9 (cammencing ' ' " �� . .
with dectlon �000) 01 Divislon 3, oT the Business antl Protessions CoOe, antl % � � � , � �' - � � '� SPECIA�L CONDITIONS: ' (7yl/�� "�� ! �.'+ 3
my IlcanSe;Is In tW force antlbfiect. I I ' " . ' • � � � ' ' � - r
LJcerix Class' �'�%Z � 'L e No:� � SG3 � � ' � ( { j PLUMBING � � 1 j � � ' � �i � � � � � " ' �
� .
o �
e
�l-�g-�ff 3 .
`ate Si natura ' . . . ,
C �--' • • 9 � �� � ! � • '• � . ' BaiSink ' ' SewerCap. � EL TRICAL �
�RKERS' COMPENSATION DECLARATION � , ; � � � ' j ' � - � + � � ! ' - � ' ' � 1 ' ' � �
� .iero0y aHirm.that I.hava a.cartlfiwta ot consentto selT-Insura or a certlflrate -�. _ 3_.. L., � _' _ . Automatic Washer, � � IMeter �over 10� amps j _ ��, 7 �!
: Backflow Pre'venter -'- � ServerConnection'� - � � -e - � �
, of Workero' Companution Insurance, or a certifietl�copy Mereof (Section ' r � � � ' - . � ' . i
�, 3800, Lab. C.) ? f � : � � , ` 1 i ' - . i M Conitruction Pole � � ; iSub Panel, { i ' - � � �
t . � f '.� � -.. � I i � . i f � � , : Backflow,irrigation � � ,,. � Solar Coliectors � , � . �i :� • � .
� ' Pollcy No: ' " - Company � � , � . � � -' ' � . i Cooking Unit � ' � ; 'Su6 Pole 1 � j t .� � 1, ' +
�. B Cartifletl�topy I5 here0y fumistietl. � � • � ; -� Bathtubs i j ; Solar Piping � � � • l i . � • i
, Certifletl copy is flletl with the clty Bulltling Dlvisbn. � � � ! , �: � �ishnvdshe� 1 ! ,Moto�s 0' 0-1'HP ❑1%$
� oace .: . - ' nvoilcant . '.'� � ... " ! i � � Clarifleri� � � . , � Solar Tank : � ( i. � ; ' . . f
��EXEMPTION'FqOMWORKERS..COMPEN5AT10NOECLARATION y . � �i� � ' �� Dryers ❑GaS��Electfic" � Inc�S010r 09.75fHP qi6-05+��
� (Thlssectlon neetl not be comoletad ii tne permit Is tor�one huntlretl (S10o) or, � DishuYdsher .� , i� � � Swimming Poal w/Spa � � ' • � � � � .
less). . �, . � 1 . , r; rl . . � � . . . � i i . " . . ' �
i- � Fan � ; !' � . Microwave r
I certlTy4hat In the periormance of the work for �whic� this permk Is IssueU I f D�inking Fou�ntains ` , U�inal � , � � �r I � ' ' "� � " ' ;'
� shallanoc employ any person in any m er so� o ecome �e to t{�e � . �, - , F,A U t � � � �Pole Light � �� � �' G �
�
; workers' Comp ensatl Laws of'Callfo . �% ' � ' , Floor Dralns - - ' { , Water C�oSet� r i. . i . i 7, � '
I Date' ��/A��519natu�e ��>�f��f�� •� � . f , n �� _. i d ' I• , �
I
NOTICE:ihaftermakin9thi5-tleclaration;you�shoultl�become-subjecbto�the�---�FIoo�Sinks�a�--L__� �..-�.......Wate�HEtte�---�-- � ��•�-;,-�-�--�•-- _.�Fixtures� � jRange,,.�._1__ �___� ! „ '� .
� '� Workers'' Compansatlon provislons oi the l.aboc Catle,. you.must_forthwlth � ,� , ' � � . . . , , � . � - .,� Device Boxes Y i ^ , � i � � . � Y ! �
, comply With� 5uch provisiOnS- or ;tni5 � DB` mit {5hat1, be �tleemetl� rBvokeG: i=, 1 G05 SErvlC9: � SOuU2t5 ��:� 7 iWatef SefVlCO �_ i` �� i`-� ^�,�� �. 'Slgn, �rt ! i
CONSTRUCTION LENDING AGENCV' " �' ' ' ' �'' ' ' ' � ' ' • .
I hereby aftirm that there is a�construction•Ien0ing agency for the.performance; � � IntErc¢pto�s � ' � �r' � _ �. :^ � ,� �7 : C% � C � li ! ;�- � ,- ' �!�j' ' Outl¢ts' I" IStending SectiOns � � F � , �
ot the work for whith �this ermit Is lissuetl (Sectlon -3097: dv C � � ' " " - r . � � �
� o.�c� � . - ' , � � „ r �. � > > . ,� - Switches � � Trash Com �j � ; � (•
� LenaerY� Name^ - Kitchen Sink - � : �, , _ ; j :�. i . 1 pac{or
Lentler'S� AOO�ecc � - � • a�/G �- � i ? . �• � �: [a � `� � - �- � . t • � i {
' � Lavatories � �` ' ., 1 > ' ry � �. � <, Gar6age Disposal � i , I � ' � �, .
'� OWNER�BUILDER DECLAqAT10N. .': : . � .. 1 � i � te . � Ry .. . "' i i k . -. � .- � . . . . � .
'. I hareby affirm that 1 am"exampt Trom the�Contractor's:License Law forthe % � . � ; f � � Gen2�ato�tO0;5 KW �5-15KW • �. � �. �, .� . (
', following reasono(Sectlon�7031:5 Business antl Profes5lonal�Cotle: Any clty or ' ' i ?-Tiep� -'. �, i,-. " � � 4 � y+�' Y' .� „� . � • . � � � s
county which repWres a permiGto construct, alter improve, tlemolish.or repair � - , ��� ^ . � � � Trensformer 015-50 KW j � � ; 1 �
�any ztructure; prior ro Its`issuance,�also requlres tRe'applicanbfor such permit , Roof;D�ams � `r' � � : � , • � ' � �` � � � r , i � ' E • � ' 1 �
.. file a 519netl statamenV�that ne/sne is Iicensetl pursuant tb theiprovisions ot '' ' ' � �' �' 5U+ KW �' � � � " �
"1 Cont�acto�'s,LJcanSe Law (Chapte� 9 (Comrtiendn9�wlth'Section:7000J of � ' � � � � � � - � � • �� ' t ' � ' " ' i i � , � iReinspaetion Fee � � $75''
`vision,3 oT the Businezs'antl Professions Cotle)�or thatlhe/she.is;exempt � � � ShOw¢�i �. ' t-. � �- 1 Beinspeetion!Fee � v��$15' , , . .� �
:;Seretrom•antl the basis for the allegetl ezemption.-Any,violatlodoi Setiion' � ' :, : , ' �, � � ' Meter ❑up to 100�amps . �IszuB FeO: � a 3
,�7031:5 Gy-any applican[ for,-a.permit,-sub�ects,tha applicant to a;civil ' -� ' c� ' __
; � lLenalty of not more than five nunUreO Gollan (E500J. . '. : . '� •. � Service Sink' I' I ,. � , E �ysue Fee �� ' '± $ 3�� ; ' , ,
LJ I�as owner of� the � ' '� - • � Zoning Approved By � Date
� property OfTTy 9�flplOyO¢5 wlth Wd9¢sas th¢i� 5018 � , , � j j � � ;' . ;
'.'comoensation wilLtlo the work, anE,theretructure ii not intentletl or offeretl '1 -;� � � 'T . j . MECHANICAL I : � �- , ; ,' qppjiptipn ApproJed By '� �✓' �-� ' � ' ' Date � '
'� for sale ;(Sec{lon 7044', Business� antl' Profeuional Cotle: The Contractor's. �� ; ����p� ' ' . , . -i`Y�-"�t--'-'-d-- I
.. . Li<ense Law tloes not apply to.an �owner o� a property who bulltls or Improves I `.. BO11ef ; ; � Refrigeretion System - � �� i t q �{ption ISsuBd B �'�x � �
thereon, anG ,who'tloes zuch work himself/herselt or through his or her own �, �� � l '� • � '� � t � y,,, �-� PP Y . . ' � Dat6
'� empioyeas, provitleE tnat such�improvements are'not Intended or otfered for . • � � oa,00,000sTu o,00,000sr,u .- _ -
� sale. If, however, the bulltling or Improvement is soltl wlthin one�year,ot com- : Duct- Under�Ground i �� � � � , ^• I � : � � � F SUMMAflV OF FEES ' � �
pletlon, the owner�will nave the burGen of proving he/the tlitl not builtl or im- ' - . .- � , �' .' .
'�rovetortnepurposeotsaie). � . � �.-. ; ! � ; � Duct-Structurel ��j . � SystemRepair/Alteiation . � yl :BUILDINGPERMIT $ l-3 � SMIP � ' ,.$ ',s_D
U I, as ownei of the property, am ezcluzively con[racting�with'licansetl con- � � F , � . , . ! � ' s�— � t
_tractorsio.construct.the`projett, Section 7064, Buslnest.antlProfessions Cotle:,_{_ _: DuctµVeMilating ,_,., , ;, __ � _ + ,_,��. F_., ' y< <PLAN CHECKI- � $ � �• PERMIT � � �
The Contractor's License Law �oes not appry to�an owner oi property who ' �, -" � � ' ISSUANCE' $�
. builtls or Improves.thereon, antl who mnSracts tor such projects wit� a con- - � Exhau5YSy5tBm ❑ Multiple O� { � ; ' '' � '� �PLUMBING � $ - � �
tractor(s) Ilcensa pursuant to ihe Contractor'S License Law)i f �� . � � � • � � ' � - � ' � � � � � � �, . GRADING , $ �
❑�I.am exemDt untler Saction t � � B, & P. C. tor this reason • Firepl/FaCt. Blt. ICBO # i '� ; { � a .. tPI.P.N CHECKj i $ , ,. • ` •_
. - 1 � s 1 � � t i 1 ; i �, �,ELECTRICAL � $ � ! r i � I i$ �
Date � �� � � Ownerf � � �- ' ` � � � H¢ating$yst2m & Ducting � � � � % ' +'y- i . .
> � •- - , i MI�CROFILM ' $ -
-h nereb tertif � that-I�•have reaE-this•a Iicatlon-ariG-sfate ttiabttie� above-� -� 00100,000 BTU•�100,OOOBT • PL,4N CHECK' + $ � � 4
Y Y. PP . .... .�._.�.. .,-.....T.p.-,-�y . . . ' I ! 2
informatlon is mrreet. I agree to <omply with all dty antl county ortllnanees ; -t e . . i � 41 ~ a � � ' �i ` ` , TOTAL'FEE; '$ i '
antliitate laws relaiin9 �to builaln9 con5truction,�antl hereby authorize reDre- • � - � �� - ; MECHANICA� ' $� � � ' ( � � � i
seniatives ot;this}cl lto e tef'dpon the ove-mentionetl .p�operty for � HoodO� Typel �❑ < < Reins eetiOn.Fee� 7 � j „ j LESS ' � ! `� E. �
insoection purpose w�/�jf?t�� � ' � F . 1 Cano . .T e II ❑� � , . . $. ' S F �
� ' Signature i ���, a "
ant; Pink - Ac<ountlng; Goltlenrotl - � � ��� - ' - � - -
, , A55Es5or � - . . . .. _ .
��? Sio ;�: � : `' Fi
{{� r.. $.. ; ; ;�',
CHy of Costa Mesa Building` �D"ept.
BY_ � ,_.,____DATE..'S.Ii� ...i4. °��
THESE PLANS MUSf BE OtJ JOB A7 ALl TIMES
MAKE NO CHANGeS WITHQUT PRIOR APPRQVAL
OF �EPT.
THE ISSUANCE 6R GRANTING DF A PERMIi D8 APFRDVAL
OF PLANS HNO SFECIFIC.^,T!ONS SH;,4L NOT 3E G�NSTROED
TO 6E A PERMIT FOR, OR RN RF�RO`:kL OF, ANY 410JQION
CF ANY �( TH: PR.OUiSiONS Oi TWS COUE. NO PERYfT PRE-
SUMIN� TO GNE AU7HORl7Y TO VfOLATE OR CA�CEL THE
PROVISIONS 6F TNI; CU6E SHALL BE VALIQ ECCEPT IP7 SO
FAR AS SHE W6RN Ok USE WHICH li AU7 HORiZES IS LAWFUL.
THE ISSU�NCE OF A PENMi( BpSED UPOf1 PLANS AND
SPECIFICAT19h5 SNALL NOi NftEVEP7T THE UUILDING OFFlCIAL
fft941 TNEitEAPTER REQt1iRING THE CORkECTIOf! OF �CRROdS
If� SAID PLANS AND SPECIFI'ATIDK3 OR FROM PREVENTIN� .
BUILDING OPERATIONS BEING 'ARRIEO ON TH REUNDER WHEN I
IN VIOLATION OF. THIS COOE OE (lNY E$ �4p�VA�G� I
�F TNE C(T�
�
= � ., �. ,
S7RUCTl1Rt�L APPR6VAL ONL�i
SEPARATE P[�MfTS ARE REQUIRED
F[1R [(.`_�_i 'CAL, PLU�1QI�iG,
HEAT;.''', i1TlLR,TiPIG ANII
PE� R! __ ;:�TION WORK
�QS�i$ :�: K� (� O_� �
TNIS iiU,: $; l;CC'.:,r1PAiVY
ALL li'S. _..1�V ^cQJcSTS
FOR BU.L...'. PERSG;:S AftE TO
BE Er �:'. � lGES7 TF�MT FHE
STATE t. 4 o;'�ris,ory aF
iM�L'S, ;Ci�lSULTED fOR
R��l1i_ . �!j$.
4s6�'v�'Fr�"'�
$TREET
�
RES��ENCE
�
� ,� -� : : :;�,
CITI' QF COSTA MESa
PI.APfNING DEPT.
EVd7ECf i0 BCQG. DEPT, REO.
SY..�� DATE.,.�.�11,$.L,�y
D Oi P1AliNtN6 � � �
qE510ENCE
TYPICAL
TOP VIE�3/8 Bar �
� � :�.
4�� Blocks B��Blocks
I/4° 0 Pencil Rod Below Top
Course Of AIl Fences
4�� Concrete 81ock Fe�ce With 8��
Pilasters. One 3/8�� Vertical Bqr,,,...---
CQntinuous _ Fcom Earfh!ootli �.Thru t
8� Pilaster. , . - ,, � �.
3/8'� Vertical- Ties ' 2�" Long ,` �
Hqoked In Footing, And: Grouted`In
4 Blocks 4''0/C: Maximum.
Provide , Cleanouf ,,And,_ inspection y
Hole At Pilasters. �
i _���
i..,�,e .... •�Ft:,i:^/Ai4 i.^. :,�,^T:::O
.............-�^""' ' W . ---'-�"".
4�� `CONCRETE BLOCK FENCE
; � � ; j "GENERAL-NOTES��
� i �� MORTAR: One Part Plasfic
�' '� Cement And Three Paris Sand.
� ii
� i� 6ROUT: One Part Cemenf And
i i � i Three And One Half Parts Sand.
I � �� COPING: One Part Cement,
; ' ; � Three Pnrfs Sand.
' � � � CONCRETE Well Mixed 1:21/2,
�� �� 31/2. Mazimum Ot 7 I/2
i ��
'' '; Gallons Of Water Per Sack
i; i � Of Cement
REINFORCEING STEEL SHALL
CONFORM TO SEC. A-i5-39
A.S.T.M. ALL STEEL TO LAP
WHERE SPLICED, 2�-O��MINIMUM.
GROUT MAY BE POURED FROM
TOP OF FENCE IN CELLS WHERE
� NATURA� GRADE-��j.:�.;��"`��� `�''e��i���°.o'e',.`O:.o:�:�".o.o p.�� �v.:.P„tic::0.o�i VERTICAI STEEL OCCURS. HOLES
�N ��i�,���,I�-�'���...Poo,�, v�� asi ��� o<�v.a SHALL BE CLEAR, CLEAN, AND
— y`Gy,.o, �• ✓ . •,� .�e.v;-��.�.� . �- 'v
fOR WiDTH SEE CHART �' �Yi<o�- .o'-'.'" I �o�� ndti,�o:
j ;p_;o �s _.� a . ti_boe ���� :a_�__); �..o=a1 ,p; �:.',i'� �__f FREE OF ALL MCRTAR, DEBRIS,
i•., �r� 1°y e � ECT. WITH INSPECTION HOLES
�' TO 16"O.C. MAXIMUM �� ����' qT BOTTOM. BOND SHALL 8E
: TWO 3/8 BARS CONTINUOUS Inl�.'e� I�B`��I
. �^��`'��i Ib,-���oi PROVIDED BY LAYING BLOCKS
FENCE MAY VARY IN HEIGHT i�e o�� DEPTH OF EARTHTOOTH I/3 i� �`I�'�i IN STRETCHER COURSES SO
FROM �3� TO 6� is :�'.ai THE HEIGHT OF FENCE iy�{°L.i THAT VERT. JOINTS ALTERNATE
STEEL MUST BE TIED IN PLACE I�.m`'i� BELOW BOTTOM oF �:-�:.a;� iN EACH couRSE.
L�,o,, ,��� FOOTING. L�?�i��
AT TIME OF TRENCH INSPECTION � /o � SCALE; I/2��= I�
3�� CLEARANCE FROM BOTTOM �`�—'1
CHART
HEIGHT . . . . . . . . . .. . .. .. . . ..6� .. . . .. .. .. . . .. . . 5�.. .. .. . .... .. . .. . . . 4�. . . .. .. .. ... . . .. . 3'
W I D T H . . . . . . . . . . . . . . . . . . . . . 14��.. . . . . . . . . . ... . . . 14��. . . . . . . . . . . . . . . . . . 12" . . . . . . . . . . . . . . . . I 2��
THICKNESS . .. . . . . . . .. .. ... .10��. . . . . . .. .. ... . . . 10��. . . . .... ... . . .. .. .8�� . . . _ ... ...... .. . 8��
DEPTH OF EARTHTOOTH . . . . . .24�� . . . . . . . . . . . . . . . 20��. .. . . ..... . . . . . . . . 16��. . . . . . ... .. . .. .. 12��
SPACING OF EARTHTOOTH....12� ... . .... ........ 14�.............. ....16�.. . . ............ 16�
City�Of Costa Mesa,California
Building Department
Fo�mBU��-7M-d-6n S-BP
OWNERS NAME� ,L//�/•_� �/�� G�� /�' ,��J _ _
JOB ADDRESS� �S��tYE)-G:Et/.C�_ LOSiAii/t�SsO
PERMIT NUMBER:_ _ _ _ _ _ _ _ _
SIGNATURE: .
2398,2 p �+ r. �p p
, COSTA MESA.BUILDING-SAFETY. DEPARTMENT 1iOTY Qf iiUS 1 R I�It�.�N
P.O. BOX 917 C08TA M86A. CALIFORNIA � �
� py,�j 1965
� For Applfwnt ro Fill� In Completely �/�PPLICATION FOR ERMIT
, TYPE OR PRINT .. � � � ���NG
BUILDINO f B U58 Ilty
ADpRE55 9Jr Che enne Street
RHCHIP� NO. �q
COSTA MESA, CALIFORNIA � � l./
PHC81V BY OA REC VED �Ai¢18SUED
� OWNER CC�Y Land Company. t�1AY 1 7 1965
BUIL�INO n /' /�
n woo`aess 1304 {Y. Co�onaeBlth Ave• AD�RE55 �i C_ 7
E�11 erton F�RE 2
� CITY ' N0.87],-271 =oNe '✓ TYPE our � '`��'
APPROVED
; ARCHITECT wBlt B0C18i TEL.S4�'b•H4 BY DATE �
�� OR ENGINEER NO.
ZONINCi � —
' ADDRESS 18368 E: 4th St. Tuatin�
_., , ZO NO.OI - I U860FN
— PIJ�NS lUILDIN
CONTRACTOR Brattain Contractors Inc: ` , o,
LEO�L
� ADDR6i8 1304 �Y. Commoneealth Ave�' DEBCRI''fl �
ciTr Fullerton Calif. ' �'P'~�� -
� � NOTE: NOfiAVEOVERHANG6HA 9E'LESSTHAN
L LIC.NO. 9O41�I NO. H�JLT2�IlO 30^TOSIDEBREARP.L.
/ EAVES
F LOT �y � X I O O I Now oN tnTe O ALLOWED ( U. B. G. REQUIREMENT7 .
YARDSAPPROVEO YARDSAPpROVED
USEOF MAINBUILOIN6 ACCESSORYBUILDIN6
EXISTING BLDG.
. ( FROM C/L STREET -
-6ETBACR LINE FNOM� � FR NT �OFT. FT.
cervrea oa srrsee� .i U REAR YARD � /�`
61DEYARDI LEFT i � I R16NT R.HIDE .7 RT. FT.
DESCRIPTION OF WORK �. sios �. Fr.
A NEW x qLTERATION _ ADDITION REAR 3DFT. ' FT. J
f REPAIR MOVIN6 - DEMOLISH � DI6TANCE BET. BET. MAIN Q `�
. MAIN BLDG8. ACCESS. BLDt35.
G/1 p YAR.3C DATE
BUILDIN6 NO.OR '
SIZE s�.l ROOMB Sf RIEB 1 C. U. P. # APPROVED
EXTERIOR WAL ROOF - APPRO (� /'
COVERING� '�tllCCO I COVERIN6 Shin Le BY DATE :S' / b.
: USE OF BUILDINO AND WORK TO BE PBRFORMED ,
b Tract 5340 — Lot 22
Plan 612E.
R-1 Residence L�% � 4it� , sa.�,
�T o
1 HEREBY ACKNOWLEDOE THAT 1 NAVB qE�O TH� �APPLICATION THE PMOUNT SMOWN UND6R VALUATION �8 POR TH8 F -
ANO BTATE THAT TH! ABOVH.18 CORHECT AND OREE TO COM• PURPOSE OF ESiA6LIBXINO • PERMIT FEH ONLY. Q
PLV WITH ALL CITY OROINANC88 ANO BiATB LAWB H2OULATINO VALUATION � O6 m
BULLDIN� CONBTPYR101 � � N
' PERMITFEE� $
v PERMITTE E OF � �'y^ � � ¢ .
� � s 2 I� � V^' A C'C�� 0.
- AUTHORIZED A6ENT � � I /p�/ LL
TOTAL FEE S ( �/ �