HomeMy WebLinkAbout2917 CHESTNUT AVE - Building Permits�
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PNOJECT RDOflESS: 2 9 1% CHES1'NUT �iV UNIT:
OWNEN'SNAME:GREENE ELISABETA H . .
aooaess:2917 C�IESTNUT AVE
COSTA MESA,CA 92626
' �(714)557=1962
RflCH/ENGINEEH: ' XEG.NO.:
RDUflESS: UNIT:
PEHMITTEE: SOUTH SHORE INllU5TRIES ( 714 ) 993-6594
AODFESS: SS MONARCH BAY PLAZA � 355
DANA POINT CA 92629
LICENSED CONTNpCTOB �ECIABATION: I hereby aihrm thal I am licensetl untler p i- ns � Chapier 9(commencing with Section
70001 nl �ivision 3 oi the eusiness and Pmfessions Cotle. an0 my��� n is in fW r a eflect.
cirvuc.:026775 STRTELIC.:92z97<�/�� .
` %,a
�ale: � L—( — � Z.. Si9naNre. _ �' —
� WOflKEflS' COMPENSATION DECLABATION: I hereby aifirm Iha� I have a ceni�icate o� consent m selbinsure or a certi�icale af Workers'
Compensaiion r ce, ���y eNy� eclion 3800, La� )
'OLICYNO.:���—��Urv�����4G E%P.OATE: SIOII93 .
COMPFNY: STATE FUND�[, �
❑ Ceriified copy is Oereby Iumishe0, CJ Cerliiietl copy is �i tl��h Ih city 'di i' io
oa�e: � 2 ' % �i Z� ppplicanr.
E7(EMPTION FflUM WOBNEflS' COMPENSATION DECLAflRTION: (This 5¢tlion nee0 na� be complet¢tl i� Ihe permit is for one hunOreO �5100) Or Ie55).
i cenily �hat in Ihe petlormance o� the work for w�ich �hls permil is issuetl. I shall nal employ any Derson in any manner so as ro become
subleci �o Ihe Workers' Compen5aiion Laws ol Cahtorma.
oa�e: signawre:
NOTICE: II, af�er making �his tleUaralion. you shoultl hecome sublecl �o ��e Workers' Compensa�ian pmvisions af Ihe La6or
CoDe. you mus� torthwrth comply wi�h such pmvisions or Ihis Oermit shall be tleemeC revoked.
CONSTBUCTION LENOING AGENCY: I hereDy aftirm �ha� there is a consimction IenAing agency lor �he petlormance ol �he work �or
w�ich Ihis permi� is issuetl (Sec�ion 3097. Civ. C).
LENOEH:
naoness:
OWNEP BUILOEB UELlABl1TI0N: I here�y aflirm Ihat I am exempt irom ��e Coniractors' State License Law for Ne following reason
(Secii�n 7031.5 Business anA Professional Code: Any city o� counry which requires a pe�mi� lo cons�mc�, al�er, improve, tlemolish, or
repair any s�mclure. prior lo its issuance. also requires the applicant br such permil to �ile a signe0 statemenl lhat helshe is licensetl
pursuanl io Ihe pmvisions ol lhe ConVacrors' State License Law �Chapter 9(commencing with Section 70W) of Division 3 oi the Business
ana Prolessions Cotle� or �hat he/s�e is exempi �heretrom an0 Ihe basis tor the allegetl exemp�ion. Any violation oi Sec�ion 703L5 by
any applicant lor a permi� sublecls t�e applicani �o a civil penalry ot nol more Ihan �ive hundre0 Oollars ($500�.
I. as owner ol �he pmperty or my employees wi�h wages as ��¢ir Sole tnmpen5ation, will do �Ae work, antl Ihe
❑ slmclure is not inten0e4 or offered lor sale (Seclion 70a4. Business antl Pmfessiunal Cotle: The Coniracmrs' State License Law
, Ooes no� apply Io an owner ol a pmpetly who �uilds or imD�oves �hereon, and who Ooes such work himself/her5el� or ihmugh
his or her own employees, proviAetl inal such impmvements are not iniended or oflereU far sale. If, however Ihe builtling or
Impmvemeni is 5oltl v�ithin one year of tomple�ion. l�¢ owner will have Ihe 6urJen o� pmving he/She Oitl noI bUi10 or improve
br ihe purpose ot sale).
I, as owner ol the property, am e�clusively contracling wi�� licensed coniractors to conslrucl the pmlet� (Sec[ion 7044, Bu5ine55
�❑ antl Pm�essions Code'. The Conlraciors' State License Law Ooes noi appty to an owner of pm0ehy who builtls or imP�oves t�ereon
i ana who conlracis for such prolecis wiN a contractor�5) license pursuant Io Ihe Coniractors' State License Law�. I am aware
i Ihat prool o� �heir Worker's CompenSalion insurance s�ould be pmvidetl m me. .
I� � I am exemp� un�er Section: B. 8 P. C. .
for Ihis reason: •
CITY OF COSTA MESA — BUILDING'PERMIT .
PERMIT NO: B 060142 . PLAN CHECK NO: .N ' . . ,
CONSTRUCTION TYPE: 5-N PERMIT TYPE: STA PURPOSE; REP ,
JOB DESCRIPTION ; REPAIR DAMAGE TO BEDROOM CAUSED BY CAR SQ FT; 1,800
CLAIM VALUE; 1,800,00 CALC—VALUE: 1,800,00 GROUP OCC: R-3 /
COMMENTS; NO PLANS REQ�'D AT TIME OF PERMIT ISSUANCE. SUBJ. TO FIELD INSPECT
���***�r**��r*********�r �e***�r**+�***�r***�r**�**��r�r**�r*���**�r*****x��**x***x�*��r�r**��� •
Z O N I N G. R E Q U I R E M E N T S
S E T B A C K S "
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGAT; FT IN
PARKING REQ• ' PROV; PARCEL; 13928419 ZNE: REF NO;
PLANNING NZSTES> ,
�
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D E V E L O; P= M. E N T S E R V I C E S R E Q U I R E M E N"T'S
:4
20NING APPROVED BY : DATE:
HUILDING APPROVED BY,:. ' DATE;
APPLICATION ISSUED 'BY� �. ���`� y��t DATE: 2" /
if�iEiFlflkiF kiFifiFklEik3kiEikifiElflEiEiEaFifiF iFiE 3F �f3F1F iFiFiF if�F'�iF3fiE�F3F3F1EiElEikiEiEiFiFlPik iF1E
iE�E1E�EiFitifiEififdEiEiFififiEifiFiEifiEiFiEiEiEjE�FiEiEikiEit-IEiEififiFlEiPif�EifiE1liFiEikiki! ik�kiEiFiE3lik�fifiEltiEiEiPiEiEiEiEiElf�FIFiEiF1EiF�F�1f
LEGALI2ATION:N F E E S U M M A R Y ' STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC , FIRE SMIP/RES GRADING
PERMIT 41,00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK. TOTAL PAID• DUE
TOTALS----> 91,50 0,00 0,00 41.50 91,50 ,00
REVENUE DIVISION TOTALS-->� COLLECTED; 41.50 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADTNG PLAN—CHECK
91.00 .SO
if if 1f lFiE if iF iE iF iF iFlF iE if iE jF iE i! iE iE i! iF !E iE iE 1E iE iElE it if iE 1E IE iF iE iE iE 1t 1E iF.iF 1E iF iE iF iE iE �E if iEiF iE fF iElF iE iE iFiE �t ik �1F 3E �f 1E iEiF if 1E iF iE 3E iE if iF�E iE 1E
2 N D I V I D U A L F E E B R E A K D O W N
TYPE
�ate- Owner �; �f � j
I tla herebY �endy I�ai I am aware ol antl untlerstantl �he reQuirements ol Cali�omia Heal�� and Satety COAe Sections 25505, 25533, an0
25534 anA Inai I or any Iuiure �uilding occupan� will/will nol (circle one) need lo comDly wi�h saitl s�a�e [otles antl Ihe requirements �or a
permil for cons�mc�ion or motlihcalian �mm Ihe Nu �uali�y Managemeni �islricL ResiOenlial cons�ruc�ion applica�ions are exemp� trom
I�ese piovlsions.
�aie: Applicant: /
I hereby cetlily Inatl have reatl�his apPbcalian xnd slaie ��at the informationis r0 'I ree�o comply wi�� all ciry and couniy
o�0inancesantlstalelawsrelalmgio�uiltlingcons�mctionantlher aut� �ereprese ive o� 5ciiyloenteruponlheabove�mentionetl
pmoeny tor insoecuon purposes. �
' Oatei / Z� l - 7 Z Signalure'., � -
Driver's License m Social Secunly a:
t6nt�t6 Whne—Builtling: Green—Code EnlorcemenC Canary—Applican�; Plnk—Revenue: GolOenrotl—Assessor
QTY
1ft00
D E S C R I P T I O N
ni,�ri�:u i�v vni,ui�: ui<�: i ni�;N r i ni
UNIT COST TOTAL COST
".,�.� . .
0
� �i�� . • �� .
i� `
CONSTRUCTION AND PIANNING P�+�L & SPA , '
APPROVALS Permit # _ � Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Sery�ce or Pole, ; 52. Pool & Equipment Location
2 Soil Pipe-Undrgrnd. ''-°'�-'Z � 53. Steel Reinforcement �
C.. � � .
LL .i ` � � ��- . ' .
,. ,r3.=Electrical Condvit I�tility-GndrgrrxY.�� 54.' Forms -. �
`�4�EFect"rical Conduit-Undrgmd, ;' �` � � - 55. Electrical Bonding � � , �
� 5:�Steel Reinforc2rrrerii _ x � . , 56. Rough P.lumbing & Pressure Test
'= 6;-�Iectrical UFEN�Grnd. �' ' S7. APPROVAL 70 COVER-GUNITE
� � ... z z
��,7�.F�ootin,gs _ ` � �; `� � _ � 58. Eiectrical Conduit-Undrgmd.
':B.:Foundation .-�r - 59. Gas Pipe, O Undrgrnd., Test
- �,
���9.`'Water Pipe-Uri�7r'grnd. �, 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Flo�or �ystem ' 61. APPROVAL TO DECK
11. P�operry Sewerv��Q & Hiwse ConFlection 62. Backwash & RecepmrFinal �
12. Sewer Cap ,-� ` � 63. Heater& Vent-Final "'
13. Roof Drains ^ � 64. Plumbing System - FinaF
14. Rough Plumbing �L 65. Electrical-Final �" � �
15. Rough Electrieel-Condult ' 66. Solar System-Final .
r'
16. Rough Electnc,Wiring ' 67. Fencing & Access ApProval �
17. Reugh Wiring�Sign , 68. APFROVED FOR PLASTERING
78. Rough ElectriCa6T Bar. Ceiling 69. POOL/SPA SYSTEMS PINAL
19. RoLgh Heating & Air Conditioning ' ` FIRE DEPT. REQUIREMENT '
��. .r - - C .Pr ::�.� .T, # -
20� RQ�gh�4act$rY iir�qPlace � �;'��, `t..� � _ �,� � : �APPR�bVCcCSy:�Pefmit #�-
- .. .: - - . -. . .
21�, Ducts,in Staucture: i �•• � - - .� 7 �.x � -• 70. �UndergYodnd Hydro '�
r� i .,
22�D�r;ts,�Wenii)ati �'�' -
4 � ;y GB* i-� ; C: � `r' �""" 71. Produc��lPjng C��as QOiI
,� :' : ., e � , : •.: v .. .
23 .GasPiqe�Rough &Y7esi � :;;� .: ; ; �.; r�..i: .: �.. 7z. Undergro0nd Flustt= x -
� - _ - _
24��Roof Fyamirtg �K ��'`•^ *= 7 _.,��; Y=.73� Undergm6.Smf'"�'eTant(,OGas �Oil
25. Roof S1�ea hing- �� �J �t " � ," ".Y � _ . `,
t -..� + v v� � Cur > 74�ldverhead Hydrq� x
26?'T�68r Ceiling (St"sucturalj &:Mon_,ocoat ` `L' �`�" K 75r Qry Cherrycal ' t �' �- � •
.:r � x " ^y �> �: r_:� _ x
27;-Frame�ndElastiirig ;.��, D��'-�- 76�-1�ryStancfpipe �',�.-�� Y� '
�28. a4hinq' SYdirlg+�c-, '""?� .� x 7Z? FIXED��TEf�Ii�INAt.y �. .-
3 /`� �''.
�29. Insulatpn� -;, "� �.� r � ��':. 7g: FIREPREV.FhNAL +�� ~
�30. DrywalFNaTnglK.; � � 1 � ^x S -HEALTt,�DEPT,REQUIREMENT
<��
-' 31 . Plaster��rown Coa� .,- ; �:�,:� � ` s � : • 79.' FINAL INSPECTIQN ., " ' -
- 32' Electrie3l P6we'r.�Me{er-Finai "'= jK �" ��� � 80^ FOOD CERTIFIj6ATE tSSUED
/" `� K R i1 x.. .�
- 33y Fi�ial E4ectric r�"": - � 4 ` r `�� `: � � -�7 " �
c ' �..i q ' NotOS: -r �r� +: ^ �
' 34� Final Heatin�`g &.Aer Conditioning �; �c �� i� � �x S r`Y. �: �
r. ,n,; r. .:'> �k s -�.: < - '
^ 35�' Final Gas P Pe-� j s� �-,n`i .: ''` _, �-: x k r n `. ;p � � - '
c� 36. Hoed oi CanoPV, < : - � 'r � . x ; A '� � i C' o � - � : .
r :t �1 ".r s f� m .rp <•� '
.. Y �:>?� :.:9 k'!C�.• . x
�37;;Firjal F,actory Fi`e,placeL � �c.. _ �,_ x Y
. . - ..- i. �' _
� 38. Fin01 Plumbing��}. ~�l � ?� i.'<. S -�- !: 3.
/,. - x
� 39. Water SBrvi�,r.e�Fi7ja� _ ' '''` ` '' ' a�''� "
i. !r x, <
q40. GasSer�yice�Final.=. - y,��. - �. r ;'+ �%�.-. v,-u
. .. ' t �. •• S !1. �� � K i � ^ "; X .
'=41. Solar pome�tic F�inal' ,,, � . h r �� �, s _ ,
:c
; - :n -� � : v - . �-, > >
42. Backflow PrevenSef *. x �z , �� =-� • �= c �-
} ,
43. Backflow Ir,%gatio;jj �. -�-'^' •0: �"` '^�'c x v :..
v x '� � t �1
_ '. � _. .. . _ �.
- 44. Landsr.ype �rrig tion System�.o�: .c �h - ' : K � .�tZ� -F .0 .
+ 45� Sound �AttenuatiUfi "^` �` � " " "'` "�' ' ' � '{`� '
o t. �+ r a. . s: �rt q r<. . t J - ra:
�46..HandicapRegulations j _ "' 1� ; �_, < �
� ��
47> FINAL STRUCTURE & BUILDING � � ^ . ^'�' _
�, .� , ,. '/.L Zz 1 D :
l. �� 1 t' N n . f .
48=FINALPL,�NNING �-�- s.; I `'� ~�± ± � �
"=49; ElectricReleasetvEdison ^ I /," *%� � - - ,
- _.x s �-�,Lx�i .�- .
"50_ Gas, Release to SoutY�ern California Gas Co -� � ��� - ., ..
; 51 � CERTIFICATE O,F. OCCUPANCY +: j .: . ;� n;- . �. �-
No. Date
�`
�cTaooeess: z917 CHESTNUT AV
OWNEfl'SNAME: GREENE ELISAHETH �•A -
nooaess: z917 CfIESTNUT AVE
COSTA MESA,CA 92626
(714)557-1962
RflCHIENGINEEP:
PEG.NO.:
UNIT:
R�DNESS: ' ' UNIT:
SOUTH SHORE INDUSTRIES (714)493-6594
PENMITTEE: S S' MONARCH BAY PLAZA 355
nooeess: DANA POINT CA 92629
LICENSEU CONTHACTOP OELLAPATION: I hereby altirm Na� I am licensetl un0er Dmv ions f Chapler 9(commencing wi�h Sec�ion
7000� p� I1lvifiitf�B Oj t�t�105it12S5 df1A P�010t5bfW�� �1 IiC¢n5¢ i5 10 Of d C�(Et�.
V L O J 9 G L G
CITY IIC.: STATE LIC.: C
�ate: : Z ` � � � �"" Signaturel _
WOPREflS' CONPfNSFTI�N,pEGLAfl9LD� � herPhy.p�irtm Iha� I �ave a�'pi�ify{¢ � c���io seli�insure or a certiticale o� Workers'
CompensaiionWa4rmcg H 6 kAdlirb la e7eA Wection 3800, La� 1/ V
Poucv xo.: STATE FUND exr. oa /n/
COMPRNY: " X �� i/
�] Certi�ied Copy is hereby lumishetl, ❑ Certi�ied copy ' iled i e mry i ion. /
l
oaie: ( -i.— � 4 z noorcznc
El(EMPTION FflOM WONNEflS' COMPENSATION OECIAflRT10N: (ihis setlion need na16e COmpleletl if Ue permii i5 �or one hunared �5100) or les5).
I cetlity Ihat in Ine pedormance of �he work lor w�ic� I�is permit is issued, I stlall nol employ any person in any manner so as to hecome
sublecl �o �he Workers' Compensation Laws ol Cdh�ornia. , .
�ale- $ignaWre: '
� NOTICE: il, alter making ihis aeclaraiion, you shoultl become sublect to ihe Workers' Compensation pmvisions of ihe La6or
. CoOe. you musl Iotlhwii� tOmDly wi�h Suth pmvisions or Ihis permil Shall 6e Oeemetl revOketl.
CONSTPOCTION LENDING AGENCY: I hereby aliirm �Aai Ihere is a canstruc�ian lentling agency for lhe pedormance ot ��e wark tor
which Inis oermii is issuetl (Seciion 3W7. Civ C).
LENDEH:
A�OflESS:
OWNEX BUILUEB OECLANATION: I here�y a��irm Ihai I am exemp� imm �he Contrac�ors' Sta�e License �aw �or I�e following reazon
(Sec�ion 7031.5 Busines5 and PmleSsionai CoOe: Any cily o� coun�y which repuires a permii Io conS�mcL alter, impmv¢, tlemolish, or
repair any siruclure. Drior lo its issuance. also requires ihe ap0licant for such permit to file a signed statemenl Ihat he/she is licensetl
pursuant�ol�e pmvisians allhe ContraclorY Sia�e License law�Chapier9�commencing wit� Seciion 7000�ol�ivision 3 olihe Busines5
and Pmiessions CoOe� or Nal helshe is exempt iherelmm and Ne 6asis for the allegetl exemption. Any violation of Section 7031.5 6y
any ap0licam lor a permil sublecis Ihe apPlicani Io a civil penally ol not more ��an five huntlre0 dollaa ($500�.
I, as awner ot I�e pm0e�y or my emDloyees wiih wages as lheir sole compensation, will da �he work, antl �Ae
❑ simcture is noi imentle0 or oflerea lor sale (Section 70a4, Business and Professional CoOe: The Contractors' Slaie License Law
tlaes nat apply �o an owner ot a property who �uiltls or impmves thereon, and who does such work himsel�/herselt or ��mugh
his or her awn emploYees. pmvi0e0 Ihai suc� impmvemen�s are nol intended or offere0 fo� sale. II, hawever ihe builtling or
improvement is sole wi�hin one year of completioq t�e owner will have Ne �urden o� pmving he/she Oitl no� build or impmve
�or Ifie putpose ol sale�. .
I, as owner ol Ihe pmDe�y. am exclusively coniracling wiin license� conVacto�s to constmc� the pmleci �Seclion 704A, BuSinesS
❑ antl Pmfessions Code' T�e Coniractors' State License Law does nol apD�Y �o an owner of pwpehy who builtls or imOrwes Uercon
antl who conlracis lor such projects wilh a conbaclor�s) license pursuan� to the Coniractors' $�a�e License law�. I am aware
Ihai pmol ol Iheir Worker 5 Compensatian insurance shoultl be pmvitled b me.
� I am exempi unner Sec�ion'. 8. 8 P. C.
lor Ihis reason:
�a�e'. Owner
I tlo hereby cenily iha� I am aware o� and underslantl �he reQuiremen�s oM1Cali�omia Heallh and Safery Cotle Sec�ions 25505, 25533, and
25534 and I�al I or any fuiure builtling occupan� willlwill noI (circle one) neetl ta comply wilh said slate maes and Ihe requirements lor a
permillor constmciion ar motlificaiion Irom I�e Air �uab�y Managemen� DisVic� ResiAen�ial conslmc�ion appliW�ions are exemD� �mm
Ihese provisians. .
�aie'. Applicani:
I hereby cer�ity Ihat I �ave read ihis applica�ion and s�a�e ihat Ihe aqyv� niorma�ion is correct. gree o co�ly wit� a0 cily an� counly
oreinancesantlsalelaw5relatinglo6uiltlingcons�mciionanahere 9aulh r�epresen,alj7 sc�isci�n ruponNea6ove�mentione4
pmperly br ins eciio purposet �
(1a1C: i �I Z, m� �
��IvOi 5 LiCC SC 0150GI�1 $CLUnIy N: -
1641-afi W�ite-9wlding-, Green—CoOe EnlorcemenC Wnary—Applican�. Pink=Revenue; Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT A: £ &6l�"�3
PERMIT NO: E 060143 PLAN CHECK NO: N �g*+�'; N �n�—#J
CONSTRUCTION TYPE; 5—N PERMIT TYPE: ELE PURPOSE: REP
JOB DESCRIPTION : REPFiIR DAMAGE TO BEDROOM CAUSED HY CAR SQ FT;
CLAIM VALUE; CALC—VALUE; GROUP OCC:'R-3 /
COMMENTS: RE: H60192 PRIMARY BLDG. PERMIT FOR DAMAGE REPAIR.
�r�e�e�ex*�r****�r��r*�r�r*�r*r***��r*****�r**+t*�r+t****+t��r+t**��e****�***�r�*�r*****+t*****�**�rx�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K.S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGAT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • PROir; PARCEL; 13928419 ZNE: REF NO:
PLANNING NdTES>
i
iF ikik �F Ik i! if if if 1f �FiF 1F IE �k iF iF iE iF iF 1! iE �f if if ik 1E iF iFlf k iE ff iE �f �FiE iF�k iF if if if iklFiE �f �Elf iF if �f iE iF iF ik iFiF iE iF * iE ik iliF iE iF iE iE M iE iF iE if !F it iF iE iF
D E V E L O P M E N T ,S E R V I C E S R E Q U I R E M E N`T S
ZONING APPROVED BY DATE; `��
BUILDING APPROVED BY : DATE: "
APPLICATION ISSUED BY: .— . DATE; l• � �
iF iF if iF iF iE �F 1F k iE if iE iF iF iF k if iF iF if iF k if i! iE iF if iFiE ik k
iEiEifik�F�F�FiFifiEifil�liEiElFMifif�fkiEiF�EitiF�kk�E�fifiElFik�FlfiFiklFlFiF�kifkiFifiFifif �Fifil�FlfififiFifififlFfE±FikifiFiFiEikiFiEiF�f3lakiE�f
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 13,25
SOt SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 13.25 15.00 0.00 28.25 28.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 28,25 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRApING PLAN—CHECK
�8,25
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I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 3 RECEPT/OUTLET 1 ST 20 EA, 75 2,25
ELE 1 MISC CONDUIT NOT LISTED REQ PERMIT 11,00 11,00
END OF FEES
ri�� .-. . _�.. .0
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CONSTRUCTION AND PLANNING . POO. SPA � ,
APPROVALS Permit # Date Inspector APpROVALS Permit # Date Inspector
- 1. Temporary Electrical Se�ice or P�al�„ .� � 52. .Pool & Equipment Location
2.�SoilPipe-Und�grn�. �^� . - 53.�SteelReinforcement . �
-,X t�� 1�. � �ni .
���r�;flectncalCor�'duit��Jti�ity-Undrg�ri¢. . 54. Forms - .
'= �.'�4.�lectrical CoKd"uit-Undrgrnd. S� : 55. Electrical Bonding - -
Fr . m
�: �i9,'�,'�i, te�Reinfot`�e��it " ` r� 56. Rough Plumbing & Pressure Test - ''�
C,�.�. . � �_ „
.'7fi+�uElectrical UF.��Ciimd. f •- 57. �APPROVAL TO COVER�GUNITE . i�
E� +
;-�;���odf�ngs H;�? ` '^ 58..ElectricalConduit-Undrgrnd. ;��
'�;r� Foundation ntn � � 59. Gas Pipe, O Undrgrnd., Test _ ry
'y6? Water Pipe-ljf�'di'trnd. . 60. Backwash Lines, P-Trep, O Undrgrnd.
�
10. Structural FloorSystem - . 61. APPROVAL TO DECK
7 L oroperty Sew% �ne & Flvuse Cotsnection � 62. Backwash & Receptor�Final -
12.�ewer Cap :� ' - . 63. Heater & Vent-Final �
13. Roof Drains m 64. Plumbirig System � Final '
74. Rough Plum�ng"' 65. Electrical-Final
75. Rough Electr.ieal-Conduit . 66. Solar SYstem-Final
16. Rough Electr.it, Wiring 67. Fencing & Access Approval
� 17. Rough Wiring�8� 68. APPROVED FOR PLASTERING
18. Rough Elect�cal�T Bar Ceiling � 69. POOCfSPA $YSTEMS FINAL
19. Rough Heating & Air Conditioning � � ' FIRE DEPT. REQUIREMENT - ' '
?�-ttwH :C '� Mh7
78'r Rougl3:FacCory:FiFeplace i �'tv `S" ^ ' �:t � tn APRROV�7F6�0 RBrmit #� >' - �
.4 'S tA �2 �� � sT x'S � � t�M r, r7 X �.O.�N := �
�-. � , ` r� � � ... �
utts;7n S`�riuci�'Gse i.... ��� S �' H:s X; 70:-+UndH�prDwd �tydro e
22. 0"�icts`Wen'tilafing t i�S ^ �yx z v ��, prod�G��pin�'�Gas �70i1
"1 eY n:.. i � H . . �
�'3, C� s P�e�Fi�ugli�k Test � �'� a "�'y: +� 'y ,'� .
t -Mj ��.n; C �^,a:=:" 72. Underg�undFJ�{sh ,yc F
i .
2�. Rt3of Traming t*1y� i F-i- •�E- ��:} O J K.� S�. Undergr?id. St�--ge Tar�k � Gas C3-L�il
25. R of'$fieathin '� ?� '-" : a' r,� n;:� ... :� - �. �.
f1 3�:,: �;;, v v�: rt7* �: �. Overhead Hyc�ro
26. TtBar Ceiling (Siaucturall:&��Moriocoat Ci' C [o,� �+� �. Dry Chemicalu'y �k `-� � ���:
� w i: =n rn��
F me.and Fla � ° ` ; r: ", r } .` =S i° � ";
�' �.� i. �.�9 �IC:S �P�F: %: ��. Dry St3��IP��t^ :.c .r;l
� 2�. L9thiolq & Sidim,� •'r� •ixt'= � � � � "� ��? �� i7. FIXEC��-'7S � 1� FINLiL� n `-�
E
29. Insulet,�on Zr:'� S��'� '.', '�`� :: Y 7$. FIRE PREV. F,�I;(yAL � cJ; j�
t 30. Drywa`ii Nailid x, � �� I �: x .-� '-+�iiEAL71i DEPT�RE@UYREMENT
._ �c n n � �v r ,
31. Plaste�Broym�t � •'�����'� 79. FINAL-�jT�IjSPEC`I�ON y'"`' � F"'r
S 1 Crrr : f �r 1 ic
33. Elect(otal Powel�dileT.er-Final .� �' oJ �' �.+ [_` 80. FOOD C�ERTI CATE�iIS�-�SUED S
�
� F,�al'Elec�ic l'-i' � � i �� . ;�� . e: .a .r �* � v 7 :! � �
�' �_ L� � ,, L � „� x NG 5: ,-,' --t�; . .1. �Cry
{� x i � �� - ,•_v, �•i� �
n 3d. al;4ieat�i.9 .�-,F,ii �onditiP.S��9 � '.C. l tr�'„•v •: CI,L .. ,� r-+n
� �. � i
35'. Ktrial'�'asPipe$2St� �' '� ' ikx ;`;N�.s O[l CnS +:C�' [�.^.
L� t F-ir h '�+ / t w-!� Ot-i :nJL�SCT'
36. Hcodibr Cano�Y < ; . v: •_. � • � ,. t : .
� :l i � ;lc� :r. �.•
3�. k'h�al��actory .�i,�idYa:�'t@ i �-J.«� v� �i� � � � ;C Y^ >.' ��i�`M
�� .^;
F 38. Firoal;fsium6ing:..a: � rU �.... y � �'%, k� 5 � x r.+ 4'
39.. VC�ter!�Service-6ir21 i 1' a r �^. . Ut0 '!' u tX
�'i N' �� % t�. :; ?' iz. Y l� 7
�" 40. Gas S cvice-Fi . �' �, , '�' `-" � "� ,
i, � ��k h7 �C�r�r 5 _n i ��:. .k v2 u.N x .
.<
41. Solar�Domestic-F5na1 i`. � ^ - r�a �; t� �f,r_� � i- a:
i n :�yx n r..r. c�• �r� n' *.?; ;�
E 42. Back{�,l�w PrevEa�`e�" ij � - "� I ; �• �: � c� � ,•.�_� '.� i�.. �-� '
.. >,
43. Backflow'I�riga�iti5n '�C.��7 � � � � 'XE- :� =' ! .
r. .r :�.1� � R N - �� (l • •
Y. tC l� � T u V ✓�..'
�, 44. Landsgape�rripa_;{onSysigm;n r; :�n; r.�- r r�p r:�S N:u �:G� :k :u r��<�
u 45. Sound At�fenuati0n i;r�E.; , � s' €-� 4 F•���*C; � i: rm u':� x:
�'� ti. 1:. [� �"r.K F C 7' .� t-.t-; v:
` 4�. Handi�ap Regula�ions `� ;� :. ir .. �..w •:: " i i �.-�v' �••�' '
i� ra .� .x i V� tr: S C�ti i
�J _j .
4�:. FJNAL S%i3UCTURE & 6411LDING �B , z�`-! n� S � s �
t
4�. F�NAL PL`ANNIf�G � t�`� � I !rfK � {� • . � ,''
I i-. �-. ; J i i: '{: tn � r; �-L ti� [�
� 49. Electric Release tb Edison i
ft �r i
� 5Q. C��s Release to SoLthern C�lifornia Gas
;, 51. CERTIFICATE .F OCCUPA'N�Y
No. Date
•T �t F'
O C .I'. Li'-
H :� � o:n i: 7� . .
t7 Mo z , ���o
OWNER gpipgys� y, J, DATE 10-17-75
JOB ADDRESS 2q17 Chestnut Avenue BUILDING PERMI7 N0.
o. 14C-?84-1Q LOT TRACT FIRE ZONE VAL
GAS
fER
ROUGH PLUMBING
PROP. SWR. LINE
SPRINKLING SVST
ROUGN HEFTING ANO FIR CONDITIONING
TEMPORNRY SERVICE OF POLE
UNOERGROUNO � POWEft �
ROUGM WIRING
TftENCHES I� FORMS �Z STEEL RE
BEAM
FqqME ANO FLASHING �_
LATHING - IN � OUT � ��.0
PLASTER_ BROWN COAT
flIII1.01NC. F�NA1 I ...l� I .�O///
SUBCONTRACTOR
�
= �� 4�739
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILOING
� ADORESS / C �
OWNEP S O " S Y.S
MAIL
ADORESS
TE L.
CITV NO� —d .
CONSTRUCTION .
LENDER �
BRANCH �'
ADDRESS �
. . ARCHITECT TEL.
REFQI��
L�
�
A.P. NO. .
BUILDING
ADDRESS
TRL
W AC
OWNER
PAIu
9CT 17-75�ri,-00 749'• ***:�60.5�
FORSTRUCTURALPERMIT
DATE RECEIVED DATE ISSUE❑
�fl�� l.
� =����Ir��
�� • � �f 77��i7RFY
--__
r.
. �
. � .vr,rnuveu �/ � DATE O'
CONTRACTOR TNO /�S -BV �
AODRESS E
� ' TEL. ZO '' NO.OF USE OF NE �
CITV NO '
—SS�O P�� � BUILDING
� STATE CITV YARDS APPROVED ' VARDS APPROVED
� LIC. NO. Z IIC. NO. �8 MAIN BUILDING ACCESSORY
{ra SI2E `� ' NO.OF BLDGS. (FROM C/L STFEET)
W OF LOT NOW ON LOT FRONT FT. F
d USE OF
� EXISTING BLDG. FT. F
h �`
FSeparate permits are required for L. SIDE O FT. F
q electric; plumbing and heating work. REAR ILa FT. � � F
W USE OF BUILDING AND WORK TO BE�PERFOfiMED
F" . DISTANCE BET. BEf. MAIN &
�Q MAIN BLDGS. ACCESS. BLDG;
; � � /J � VAR.# ' DATE
a LU C.U.P.# APPROVED
� � APPROVE _/ O' I
f�
.� .
�i
W
� I hereby acknowledge that I have reatl this'application antl stata
a that the above Informetlon is correci and ag�ee to comply with
a ell laws regulaiing building construction,�antl I shall not employ
Wany oerson in violation of the workman's compensation laws of �
S the Stete of Californie.
3 . I hereby certify Shat I am properly Iicensed as a conttactor under SQ. FT.
the Stete of California Business and Profassions Cotla, Divislon 3, THE AMOUNT SHOWN UNDER VA�UA
Chapter 9, and that such licansas are in full forca antl affect, or I THE PURPOSE OF ESTABLISHING A PERMI
am exempt from the provisionsot theStata of Celifornia Business .VALVATION
antl Professions Code, DiviSion 3, Chapter 9. ' , PERMIT FEE $
SiBnat ra of / �` PLAN CHECK $
Perml r S���/ (! TAX E
Authorize Agent ' TOTALPAID $
n
m
i
m
m
N
IS FOR m
ON�LyV��:
.�
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d-N m
0
LL
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
� fOR APPUCANT TO F/lL /N COMP[ETELY
� TYPE OR PRINT
ADDRESS 2917 Chestnut Avenue
COSTA MESA.-CALIFORNIA
OWNEft Adams Acres, Inc.
ADDRE55 �9 �• 1(th St•
cirv Costa idesa TNo LI87159
ARCHITEGT Carlson & LIC.
OR ENGINEER __. _ __ _ _ NO.
�b. Y{t.li���' . �_v.
f �1' �rUr � 19�9
1-�k�r;ill�� �.JEf�.
, �,,,,•z, nt�c,,
APPLICATION FOR PERMIT
BUILDING
�oR officF usF oNcr
6Y
COSTA MESA. CALIFORNIA
FIRE �I /
ZONE TYP�V"- GROIJP � ' �
CONTR,Pc�b� & Colegrove, In LCTNTO.Zp 2 BYPROVED DATE
ADDRE55 �9 E. 17th St.� Costa Mesa ZONING
LEGAL I LOT S/ I I ZONE NO.OF USE OF NI
OESCRIPTION NO. � V BLOCK TRACT �!/ I PLANS I Bf11LDING
A.P. NO. APPROVED
-_.__ -.----. --. -... .. - BY /A � DATE
60 x 115 ���w°g W; �;s
USE OF
EXISTING BLDG.
SETBACK LINE FROM 55� REAR YARD �O,
CENTEF OF STREET
SIDE VARO ILEFf � IRIGHT �
DESCRIPTION OF WORK
NEW I �IIALTERATION I IIADDITION I
REPAIR I IIMOVING I IIDEMOLISH I
BUILDING 1365 NO.OF 6 1
SIZE ROOMS STORIES
EXTERIOR WA�iuCCO ROOF
COVERING �� COVERING rock
US OF UILDING D WORI(TO BE PERFORMED
S�in��le famiF'%y residence with.
attached garage.
I HEREBY qCKNOWlEOGE THAT I HAVE REAU THIS APPLICATION
AND STNTE THAT THE ABOVE�IS COFRECT AND AGFEE TO COM-
PLY WITH �1LL CITY ORUINANCES AND STATE LRW$ REGVLRTING
BUILOING CONSTRV���� �
SIGNATURE OF � � �/, wE�
� AUTHORIZED AGENT Dike & ColeFrove, Inc.
0
�CENTER LINE.6T.�
R. 51
REAR
THE AMOUNT SHOWN IINOER VALlIAT10N IB iOR THE
PURPOSE OF E9TABLISHING A PERMIT FEE ONLY.
VA�UATION nn
PERMITFEE $ 32�W
� �3�7�5 PLAN CHECK $ ZO�OO
TOTAL FEE $ �•�