HomeMy WebLinkAbout3189 COUNTRY CLUB DR - Building Permits.�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address: 3198 COUNTRY CLUB DR
Suite No
Vicinity:
Parcel Number: 13912301
Applicant: ADOLFO IBANEZ . -
Address: 3366 E LA PALMA"AV �-' ",�-
ANAHEIM, CA� ., � � '
r
owner.% 'ARIMURA; EDWARD
;
Address:- -�3198 COUNTRKCLUB LN, '
' �COSTA MESA�CA
_ �.
, �
Contractor: ECONO AIR
' Address: ' 3366�E LA PALMA AV
� •tANAHEIM,CA
n
Status: ISSUED
Applied: 10/21/2004
Issued: 10/21/2004 '
/
ISSUED BY:
Phone: (800) 503-2666 Jf ` �
Zip: 92806 ' � .,� � � -
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Phone: �,A ( ���,�i
ZIp: 92626 � �� . �A
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Phone: (800) 503�2666
�� -Zip; 92806 �
License:445220 � �
SCOPE OF PERMIT
: INSTALL NEW A/C UNIT AND CHANGE OUT FURNACE ��
. . ' ' Quantity � - - � - � �' Quantity:,
ISSUE-FEE • � $23.50 Repair / Alt Ab'sorbtion Unif ' ' �', $0.00 . 0
Inst FAU <100 k BTU � ,�� $14.80 1, .. .� �t� ' _ - _ Repair / Alt Refrigeration Unit „� �: $0.00 0 �,� ,
Inst�FAU>100kBTU �- $0.00"'-0-- ��°''� '�� Ventillation'Sys_tenr ; i: �$0.00 ,_-0' !�� '
Repair/Alt Cooling/Heat $0.00 - 0-f_� _ -. '� � _ � -_ �Evaporative.Cooler4 �, „, $0.00 0' ,��� �
InsU.Rep. Recess Wall Htr $0.00 ��0� �� � �- `' Com`me'rcial`Incinerator ; ' � $0:00 -� � 0 �
Refrig Sys <100 k BTU�.�,' $0.00 0 � Domestic Incinerator � ;%,y $0.00 �� 0 J„'
Refrig.Sys>100kBTU,�.� $0.00 0 Compressors�/AbsorptionSvstems �%�',` ` ' /
Gas'Piping , �, `, �V '� �� ` $0.00 0 Up'to 3�hp / 100 k BTU ` �, �i! f$O.Od� � 0'r+'
Factory�Fireplace,i ��� �` ��, ? $0.00 0 y :. ,�,,.,3 To 15 hp / 500 k BTU � �% � / ,-'$0 00 ' 0; � 1 �
Hood w/Mecli Ezhaust �� � $0.00 0 ��� s'�� �'--75 To 30 hp l 1,000 k BTU , //;/% �$0.00� �0,� �`
VAV Box��' �� t � � � �� $0.00 0 � r. �� � � 30 To50 hp / 1 750 k BTU - �! � $0.00 �,�0�
Vent Fan / Single Duct-` , ���? �$0.00 0 ' , � •,, =� Over 50 hp %:Over 1 750 BTU ' i ' , ' $0.00 � �, 0
App6ancet��: � '_ �� �$0.00--:0 . - ' Boilers � - � ' ' �. � . � ��� �
Fire Dampers � � /' , �$0 00 A ° - � ; � Up to 3 hp, ,° �, / . , $0.00��: 0
Smoke Dampers� ,� / �`�' � $0 00 0 , 3�To 15 hp - ; � : � � . ,$0.00 0
Inst or Relocate Appl Vent-� � � ! : $0 00 ��0 . � _ _ .� " 15 to 30 hp'- �,;., � � � � �.$0 00 0
Air Handlers < 10000cfm , /j�$0 00 0,`�`> .�, � � „ .�30 to 50_hp� ,�� i �i $0.00 0
Air Handlers > 10000cfm�`� � ' $0.00 �� 0 � - , : _ --.Over-50 hp> : , � C A 'i !' , i� --'/�$0.00 0
Floor Fumace � �`��� � $0.00�� 0" � ` - � - -- Othe� Mecfianical Pee ' . ' '
FloororSuspendHeater�`�' � $0.00�:,0-'. Invesligation•.Fee�� - $0.00
�� � . ' � �'- , �i _PlanCheck�Fee � � $0.00
�\ ' �� � , �'- ` ' . Reinspection�Fee � $0.00
�
� ' �� - ,, . ,.
'�� - -
�.,,� ����, -- � �� � � I � - � �% . '
-- J TOTALcCACCULATED FEES $38.30
' � � �_�' -;�.�' � ' . '
NOTICE: The work authorized by this permit shall comply wflh all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRATION: This permit shell automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
� required Inspections end finel epprovel must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aa&a8 (B/00)
WORKERS' COMPENSATION DECLARA710N: � . � � 7
I hereby aXirm under panalry oi perjury one oi the tollowing declarationsi ' . _' �, ' '.
❑ I heva entl wlll maintain e cenificate of consent to self=lnsure for workers' compansation, es provided tor by section 3700 of the Labor Coae, for the pertormance ot ihe
work for which ihis permit is issued. � , ."
❑ I have end will maintain workers' wmpensatlon insurance, as required by section 3700 of t�e Labor Code, tor ihe peAortnance ot the work for which this pertnit Is iuuetl.
My workers' compensatl n Insurence/�arrier and policy numbar ere: c�,,�,� ,.., ��, r
Carrier. S 7'W('C � l,L YW Policy Number. �, �2 P�'1 ' "�' �' i
(Th/s section need nof be complefetl i! fhe permit is velued ef one huntlretl tlollers ($f 00) or less.) . . . ... . . . .
❑ I certity that in ihe pertormance of Ihe work for which ihis permit is issued, I shall no� employ eny peison in eny manner so es to become subject to �he workars'
compensetion lews ot Celifomla, and agree lha I I sh�tl become subject to iha workers' compensation provisions oi Saction 3700 of Ihe Labor Cotla, I shall torthwlth
comply with these provis� n��s.� Q
Applicent SignaNre: �w�I U Deta: � O' Z( � C9`/
WARNING'. FAILURE TO SECURE WORKE ' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE (5100,000), IN ADDITIIXJ TO THE CQST OF COMPENSATION, DAMAGES AS PfiOVIDED FOR IN SECTION 3�W OF THE LABOR CADE, IMEREST, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby affirm that I am
force and ettect. Lic. # _
Coniractor's SignaWra:
of Chapter 9(commencing with Section 7000) ot Division 3 of the Business antl Professions Code, ena my license is in full
Class N • O ^— Zt—i
Date: '?_ � — CJ �.
CONSTRUCTION LENDING AGENCY:
❑ I hereby eNirm that there is a constmction lending agency for ihe pedormance of ihe work for which this pertni� is issued. (Sec. 3097, Civil Cotle).
Lender's Nama: Lender's Adtlress:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm thei untler penalty of perjury ihet I am EXEMPT FflOM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or counry which requires e permit to construct, elter, improve, demolish, or repair any structure, pnor to its issuance, also requires ihe applicant tor such permit
to flle e signetl statement thet he or she is licensetl pursuant to ihe provisions of the Contrectors License Ww (Chapter 9(commencing with Sectlon 7000) of Division 3 of the
Business ana Protessions Code) or ihat he or she is exempt therefrom end Ihe basis for the allegetl evemption. Any violation ot Section 7031.5 by eny applicant for e pertnit
subjects the applicant to e civil penalry of not more than fiva hundred dollars ($500).):
❑ I, as owner of �he property, or my employees wi�h wegas es their sole compensation, WILL DO THE WORK, and the s�ructure Is noi intentled or offered tor sele (Sec.
7044, Business and Professions Cotle: Tha Contractors License Law dces not apply to an owner ot property who builds or improves thereon, and who does such work
himself or hersetl or throug� his or her own employaes, provitletl ihat such improvemenis are not intendetl or oNered for sale. If, however, the building or impmvemant is
soltl within one year of completion, the owner-builder will have ihe burden of proving that he or she tlid no� build or improve tor purpose oi sale.). �
� I, as owner of Ihe propetly, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consimct tha project (Sec. 7044, Business end Pmfessions
Cotle: The contractors Ucense Law tloes not eppry m an owner oi propetly who builds or improves ihereon, and who comracts tor such project with e contremor(s)
licanse pursuent b the Contrectors License Lews.).
❑ I am exempt untler sac. Business entl Protessions Code for this reason:
Signature: Date:
Owner ID verifietl by tlnvers license. ❑ Ves ❑ No Drivers License No.
Veritication ot Ownership by (type of tlocument, i.e. - properry tex bill or deatl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Expires:
❑ I heraby certity ihat no excavation tive (5) or more teei in depth into which e person is requiretl to tlescend will be made in connection wi�h work euthonzed by ihis
permit, end ihat no building structure, scaHoltling, talsework, or demolition or dismantling Nereoi, will be more ihan thirty-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Calitornia Atlminisirative Cotle).
❑ As owner-builtler, I wiil not employ anyone to do work which woultl require a permit irom ihe Division of Indusirial Sefery, as noted above, unless such person has e
permit to tlo such work trom the tlivision.
Signature: Date:
Division ot Industrial Safery Pertnit Numbar.
CERTIFICATE OF COMPLIANCE AND AIJTHORIZA7ION OF ENTHV: I cenity under penaly of perjury that 1 have read fhis epplication antl slete ihat ihe information given is
corred. I agree to comply with all steie laws antl ciry ordinances ralating to building consiruction, end authonze representatives of ihe City of Coste Mesa to enter upon Ihe
above-described property for inspection purposes. I agree not to occupy or allow occupancy ol any building authorized by this permit until finel inspection.
CODE I, INSVELTONTYVE
1616 Fizad System Final Fire Prevention
1266
200
201
202
203
204
Pool Spa Finel
Final Re-Roof
Final BIocWReteining Wall
Final Factory Fire Place
Finel Sign
Finel Demolition
Pi7F INTRI�LS
CO�E� INSVECTIONTYPE �
206 Final Mechanical
208 Final Plumbing . �
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval �
222 Final Site
250 ' Final Building/Occupancy
Date
_� _
� _ 1 .1111.
■ r � � \
t
� Aoo��cant lo till in all spaces except thase within heavy bortler lines ana sign all approoriate aeelarations.
�✓� cITY��F coSTA MESA ; CONSTRU TION PERMIT
�rojec[ Addre� ��� y .Ca�� cl6
� . �
�lCp�litnrtt's Mailing Address
Owner'sName ��" G'��10� PhonesYJ'11�s
Address `'r4"v e � �
ArchlEng. _ License No. � ' �
Address , - ; ' � � � ' �
Contrector's Nam L� �- � '' ��' Phone 63'�y��.
' Address (mailing) � �-�� � �^' �
Ciry Licen'se No. � � ' � � '
LICENSED CONTRACTOR DECLARATION
1 hereby attirm Ihat I am licensetl untler provisions of Charter59 (commencinq
�with sec[ion 7000) of Division 3 of the Business antl Professions Cotle, antl
my license is in full orce ana ettect. 6
1 L'icense Class �' 3 � Li , srJytr. �zY �,
, � Oate � � �fr Signature ` � � ' �
v WORKERS' COMPENSATION DECLARA ION' �
' lereby atfirm lhat I have a certificate ot consent to self-insure or a certiflcate
� workers' compensation Insurance,tor a-certifietl-copy^hereot-(Section
\ ,00, Lab. C.) � i �
` Po icY nio. 0.2 /tiG'E-Zo j9S�C comPanv E�O�" e..�n,r; '
i �
� Certifietl copy is hereby furnishetl. n �
Cevtifietl capy is fil¢tl with the city Buil i� g L]7k'sion .
Date �G /-�� APPlicant r/' �
EXEMPTION FROM WORKERS':COMP SATION DECIARATION �
(Thissection neetl not be mmpletttl if the permit i5 �or one huntlretl (E100) or �
ie��,.
I certity thai'in the p¢rformance of the wo�k for which th15 perm�t is issuetl, I
snalll not employ any person in any manner so as to become subject to ihe
Workers' Compensation' Laws of California. ' � .,,
Date • Signature � � �
NOTICE: It, aRe� making thi5 tleclaration, you sM1oultl become sublec< to the
Workers' Compensation provisions ot the Labor Cotle, you-musC(orthwith
comply 'with Such p�ovisions or thi5 ,permit, Shall be tleemetl revoketl.
CONSTRUCTION'LENDING�'AGENGV' I - ' � ° '
I he�eby dffirm that the�e is a construction lentling agency for the pe�(o�mance
of the work tor wh�thi5 permit. is issuetl (Section 3097 Civ. C.)
Lentler's Name - ' L
Lentler's Atltl�ess � -
OWNER BUILOER DECLARATION � �
I he�eby affirm [hat I am exempt from the Cont�actor'S License Law to� the
followinq reason (Sectfon 7031.5 Business antl Pro(essional Cotle: Any city or ,
county w�ich requires a permit to construct, alter, improve, tlemoiish or repair �
any slructure, p�ior to its issuance, also requiresrthe applicant for such pe�mit
to file a signetl'itatement'that he/sM1e I5 li<ensed'pursuant to the provisions of
• ine f.nntractor's License �aw ICnaoter 9(commencinq witn Section ]000) of
efrom antl tbe basis�for tne allegetl exemption. Any vlo�aUon oi Secnon .
1.5 by any appli<ant to� a permii Subjects the_aOPlicant to a civil
.iaity of not more than five M1untlretl tlollars ($500). � •� ' '_ �
L� 1, as owner ot the prooerty,or. my emplbyees with wa9es as their sole �
compensation, will tlo the work, antl the'sVucture is not intentletl or oiferetl
for sale (Settion•7044, BuSiness antl Professional Cotle: The Contractor's'
l.iren5e'Lzw tloes not appry to an owner of a property who builtls or improves •
thereon; antl who does such work hlmself/herself or throu9n his or her own
employ¢es, provitletl that such imp�ovements are not intentletl or ofteretl to�
sale. I�, however, the builtling o� improvemenl is soltl within one yea� ot com-
D�etion, the owner will have the bur�en of proving he/sM1e tlitl not builtl or im-
�rove tor the purpose of sale). ' '
I,'as owner Of the pwpe�ty, am exclusively toM�acting with lic¢nsetl con- �
tractor5 to tonstruct the project (SectiOn ]044, Business and Professions Cotle:
� Tbe Contractor's -License Law tloes not.apply to an owne� of �p�operty who
builtls or improve5 thereon, antl•who mntracts fo� such p�ojects with a con-
' tracto�(s) licen5e pur5uant to the ConVacto�R Licenie Law). I am aware that
proof o1 tneit Worke�'S Compensation insurance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. tor this reason �
t
Date Owner -
I hereby certi(y that I have reatl this application antl state that the above
information is correct. I agree to comply wi[h all dty antl county ortlinances
antl sfate laws �elatinq, to builtlin9 mnstr �� ion, antl he�eby authorize repre-
sentatives of, this ci 1 to fer upo e above-mentionetl property for .
InSpection purpOses
U• �
e
TVPE OF CONSTRUCTION ❑ NEW CJ ADD ❑ ALTERATION �I�REPAIR ��
❑ CONVERSION �❑ DEMOLISH ❑ OTHEfj, � A'p: #�
.DESCRIPTIONOFWORK/USEOF�BLDG. ��'-%'� � �
. - S Main Building:
TVPE'OF PERMIT GRADINc FOUrvDA7lorv 57RUCTURAL T Front - _
❑ TENANT ❑ EpLECT�RICA./LI ❑ PLUMBING ❑-MECHANICAL _ A Reaf " �
�OTHER ' /�p.rpOTin� �
P�ECT DESCRIPTION SQ. FT. �9�� � C Right
OCCUPANCV� K�
� CONSTRUCTIONTVPE VALUATION$ �S9Q� g Left �
�
ZONE GRADING CU. VDS. ACRES � pjng. Ref. #�
Remarks: ; �� ' ' � ' � ' � Plannin9 Notes: ,
3ar Sink �
3ackflow'Preventer ` ' ' ' �
3ackflow Irrigation �
Bathtubs ' � • �
Clarifiers '
Dishwasher � '
Drinking Fountains � '
Floor Drains • �
Floor Sinks � - - -
Interceptors' • i � ".
Kitchen Sink '
Cavatories '
P=Tiap � i
Roof Drains �
r 1 _
Reinspaction Fee � � $15
Duct - Strucmral , ,
Duct-Ventilating _- _ - ._
Exhaust System ❑ Multiple �
Firepl/Fact. Blt. ICBO #
Heating System & Ducting ,
❑ ai oo,000 eTu O i'oo,000 s
Signature . . . � �ate��� I I pains ection Fee ' I $75
Drivers'� License a 55 # �� ' ' P
CMF 0865-46, rev. 4/84
White - Builaing; Canary - Applicanq Pink - Accounting; Goltlenrotl - Assessor
IMBING �
Showers '
-ServiceSink , . -
Sewer Cap '
Sewer Connection .
Solar Collectors
Solar Piping�
Solar Tank - � �
Swimmin9 Pbol w/Spa�
i
Urinal
Water Closet � �
Water Service , �
f
�SSu¢ F80
t
Hood oc Type 1' ❑'
CanoPV TYPe I I ❑ ,
Refrigeration System
❑0-t00,000BTU ❑100,OOOBTU
� System Repair/Alteration '
Isue Fea
$� 3
$ 3
- ..
�
` _ " i '
9,1.92, 10/01%Bu ' . , j7.50 iL�
_ ' • Zone
Accessory Building:
- i ..
Parking Req./Provided
i. .
ELECTRICAL
Automatic Washer ' " Transformer ❑ 75-50 KW •
Constructior Pole Sub. � � ' , ❑ SO+�KW .
Cooking Unit ' � • ' � Meter ❑up ro 100 amps
Dishwasher ' � Meter ❑over t00amps
Oryers ❑Gas ❑Electric � Sub Panel �
Fan ' Motors�0�1HP�1%�-8
F.A.U. � ' Inc.Solar �9-75 HP 016-15+
Fixtures' .- -- - � Microwave � -
Device Boxes Pole Light �
Outlets � .Range '
Switches Sign
Garbage Disposal •
Generator �0.5 KW �5-15 KW
Standing Sections
Trash Compacror
I Reinspection Fee I$15 I I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zaning Approved By
Building Approved By ,���—
Z
� - . O
- N
� �
- N
G
R
E
Q
' M
T
S.
FEES
�
��
$ 3
SUMMARV OF FEES � O
BUILDING PERMIT $ �� •��J SMIP � $ �%
P.LAN CHECK ' $ - ' �PERMIT, '
� PLUMBING � $ � ISSUANCE $ �
PLAN CHECK 25% $ � ,ENERGV P.C. $
� ELECTRICAL $ ' GRADING � $ �
PLAN CHECK 50% $ ' �MICROFILM $
MECHANICAL $ � TOTAL FEE . $ � IC� •���
PLAN CHECK ZS% $ ' � �
7
' . . - � . POOf 7A
, CONSTRUCTION AND PLANNING' ' � ' '' • ' � . ' • _
,,APF�AOVALS�� �Permit# ` Date Inspector .�p�ppROVALS -Permit# M_Date Inspector -
1�,Temporary Electrical�Service or Pole 52: �Pool & Equipment Location' � � .
��'2. SoilPipe-Undrgrnd. �' . .� � , . �. .53:"Steel�Reinforcement ' - �
3. Electrical Conduit Utility�Undrgmd. � - 54: Forms . - " . � - '
4. Electrical Conduit-Undrgrnd. � ' ,. 55.'�Electrical Bonding' . � � . . �
5. Steel Reinforcement '. � �. � � � 56. Rough�Plumbing & Pressure Test �
6. Electrical UFER Grnd. � • � 57. APPROVA� TO COVER-GUNITE �
J. Footings � � '- ' � � . . 58. Electrical Conduit-Undrgmd: - � '
•8. Foundation ' � � ' � 59. Gas Pipe, O ,Un`drgrnd., Test � �
'"9. Water Pipe-Undrgrnd. � , 60.� Backwash Lines, P-Trap, O Undrgmd. �
10. Structural Floor System . . ' - 61. APPROVAL TO DECK ' -
11. Property Sewer Line & House Connection �62:- Backwash.& Receptor-Final' _ ' � -
' 12. Sewer Cap � ' 63.r Heater & Venf-Final ' �
- 13. Roof Drains � .� , 64. Plumbing SYstem - Final: �
14. Rough Plumbing . �65. Electrical-Final � � ' , ,. - �
15. Rough E�ectrical-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 , � , ' , i 90.� Underground Hydro� � � " - � - '
22. Ducts, Ventilating � . 71. Product Piping O Gas ❑ Oil , , �
23. Gas Pipe-Rough & Test � � ' 72." Underground Flush " � � � �
24. Roof Framing � � � � 73.. Undergrnd. Storage Tank,O Gas ❑ Oil ,
� 25. Roof Sheathing � 74. OJerhead Hydro .
�26. T-6ar Ceiling (Structural) & Monocoat ' - � 75. Dry'Chemical ' � , �
27. Frame and Flashing � „' . � � 76. Dry Standpipe � , '
28. �Lathing & Siding •77. FIXED SYSTEM FINAL
29. Insulation � � 78. FIRE PREV. FINAL � �
30. Drywall Nailing � ' , � HEALTH DEPT. REQUIREMENT �
31. Plaster Brown Coat . , '� 79. FINAL INSPECTION � �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' ' Notes: . , ' . � � �
34. Final Heating & Air Conditioning ', � '� �
35. Final Gas Pipe-Test . � ' , . . � , • '. �
36. Hood or Canopy _ ' . " . � , - '
37. Final Factory Fireplace , � . �. � - . �
38. Final Plumbing • . ' ' � " ' ' - . ' �
39. Water Service-Final ' , ' ' ' ' ' � '
40. Gas Service-Final . . ,
i �
41. Solar pomestic-Final _ . �
42. Backflow Preventer . � ' , ' ' � - � �
43.-Backflow,lrrigation. .. ,.,.,. � __ _ � - - �. , . �, �
44'. ,Landscape Irrigation System _ � ��
�. ..
45. Sound Attenuation � ' � � ' � .
�
46:. Handicap Regulations r � � - ' •
.l
47. FINAL STRUCTURE & BUILDING. � �� , � .
46. Special Requirements Completed � -� .. �
49. Electric Release�to Edison � . � -� � �� � -�• � � � - � � � �
, �
50l' Gas Release to Southern California Gas Co - � i � � �
51. CERTIFICATEOF.00CUPANCY _ , , .�_ � - . � " '
No. � Date • ' :
_ MNIN OFFICE
1695 WEST GAYLQqO ST.. - P.O. 00% 9063
LONG BEAGH 10, CALIFORNIA '
HEM40CK 5-�493
BPAUCE 5�20BI
Twini�a
Examination No.
Project
Sample from ,
Architect
Contractor
'J
BF�NGH OFiICE
1l19�D NORTH HI.RVER 6T.
S�NT� /.NA. CALIFORNIA
JEGiEF50N L2013
JEFFERSON 1-2066
Labora�orses of csout�Ze¢n �a�ifoznla, �nc.
November t7, 1960
Gl1NIT�
REPORT OF TEST CYLINDER
SC60-782
Far - Anthony Pools �
ZO50 Harbor; Costa M11esa, Calif,
RAY H. CORRALE RESIDENCE - 3189 Country Club Dr„ Costa Mesa
Gunite Swim Pool Calif.
Anthony Poo1a
M�x
�✓ater, gal./sk. cement
�Btetx�x Size 6-i/8 x 11-7/8
Date cast 10-20-60
Date tested . " 30-27-60
Cylinder No. i
COMPRESSION TEST 7 Days
To[al load to,destruction, Ibs. 68,500
Pqunds per'square inch 2,325
Cylinder made by
Cylinder delivered by
Cylinder received on
cc: Ant6bhy Pools
Ray H, Cozrale
Costa h7esa Bldg. Dept.
SA Lab
5 7/8 x 12 I/8
11-17-60
Fa
28 Days
b5, o00
� - `^
2.398
Gunite Crew - Van Roy
C. Cribbs
10-21-60
NOJ ?,i 1g�v
C�<B�, d og p p�s�
�% (G '�b V�y-�y
��1,� �,� ,
r
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•Ll REPONTS AFE SUBMITTEO A9 THE CONFIDENTIAL PFOPEFTY OF GLIF�NTS. FUTHORIZATION FOR PUBLICATION OF O{IR REPORTS, CONClU510N9. OR E%�
TRACTS FAOM OR REGARDING TH£M IS AESEFYED PEN�ING OUR WFITTEN APPROVAL AS A MIITUAL AROTECTIOII '!O CLIfNTS, THE VUBLIC AkD OURSELVES.
�\ \
OWNER �A�
JOB ADDRESS
GENEItAL COL
INSPECTIONS
OCCUPANCY
Form 210—SM-11-59 S-B P
ROY
DATE
SUBCONTRACTOR
DATE 10-17-60
BUILDING PERMIT NO.
_�
��.
• �.3��JC3
COSTA MESA BUILDING-SAFETY_ DEPARTMENT
�P. O. BOX 917 CP87A MEBA. CALIPORNIA
For Applleanf io Fill In Complefely
TYPE OR PRINT - �
ADDRESB �� p CO N�R �CG �
. COSTA MESA. CALIF RNIA
,.,.,.,., `�_ _ (� a v o „ L �
TEL.
3,
cin :� -.. 1� R � �- A L .
LIC.TNO. ' � � � I . NO. �— / `O % L
OF LOT qy "n �� �� f r ` (� � No. aF BLDGB.
� J I�� NOW ON LAT
USE OF
EXISTING BLDG
SETOACK LINH FROM
cern'ex or srneer REAR YARD
SIDE YARD I LEFT - I RIGHT
DESCRIPTION OF WORK
WALL
ROOF
COVERING
K TO BE PERFORMEO
FEE RECEIVE� �
J'�'• l "� � d — �
FINANCE DEPT.
AP�kICATIOM��iOR�tE HMIT
BUILDING
For Office Use Only
NEGEIPT NO. I P[RNIT NO.
COSTA MESA. CALIFORNIA
APPROVED
ZO I NO. OF
� runs
LEGAL
YARD6
APPROVEO
tcervTew urve er.�
APPROVED
NIIdG ' Q
III6E OF NEW
BUILDINO
���
�
EVES
�.+ ci y� ��) � d c.�/
/ � / � �/� // ,:
I HERBBY AGKNOWLEGGE TXAT i XAVB R6AD THIB APPLIGTION TH! AMOUM BXOWN IINDER VALl1ATiON 18 FOR TN¢
AND BTATE THAT THC ABOVE IB CORRECT AND AORE6 TO.COM-
PURPOB¢ OF, EBTABLIBHING A PERMIT FEE ONLY.
PLY WITN �LL CITY OIiDiNANGee AND BTATE LAW6 RE6UTATINO
euu.o�no conernucnon. � . VALUATION � y'/
SIGNATURE OF ���`'��,..� ..�1 �a � � PERMI7 FEE $ �
PERMITTE
S PLAN CHECK $
AUTHORIZED AGENT ja �
TOTAL FEE
oWNER CARROLLJ R�Y H. � �U6 3 0 19� DATE 9=29-60
JOB ADDRESS Ouri Ty u P, BUILDING PERMIT NO.
GENERAL CONTRACTOR Anthony Pools VALUE SZ. OO.00
INSPECTIONS I DATE
SUBCONTRACTOR I PERMITSISSUED_
O
�
�p suilding, Fina1
�� OCCUPANCY
Form 416—SM-11-59 5-B P , 1'2cJ17
�` 12�1'�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 CDBTA MEBA. CALIPORNIA
For Applicanf fo Fill In Complefely
TYPE OR PRINT �
ADDRE65 3189 COL3NTRY CLUB DR.
COSTA MEBA. CALIFORNIA
PL
LOS
:TOR arrTxo� PooLs
5871 FZRESTONE
SOUTA GATE
SIZE
OF LOT
U6E OF
E%ISTING BLDG.
SHTOACK LINH FPON
�p 32210
I NO. OP BLDOB.
DESCRIPTION OF WORK
r� \
WALL
ftOOF
COVERING
K TO BE PERFORMED
FEE RECEIVED
�� a 9-i96o
APPL�TI�N"��A��VI tJH�
vr
BUILDING
For Office Use Only
' I/ 7� a-7 �i
41 BUILm3 G y �j
AOORESS O
COSTA MES CAWI
PIRE
ZONE TYPE `'
APPROVED � `
Z�ONING
z��--'� I i�erve y/I eu �o�rvc
oeewxirrioH �U t I d 7 ��
A. P. NO. / I h �,5�� r
YARD�� EVES
APPROVED ALLOWED
iceHrew u�¢ sr.� y'�'�� � � ./� �
FRONT 7.iF FT. (,(/��
r��
R.SIDE // �FT. (�//y✓
L. SIDE L/, � FT.
I �
REAR ( D � FT. ��
i�
ePPROVED �I /I '! � ...r�
v
1 HeREBY pCKNOWLEDOE THAT 1 H/�VE REAp TH18 APPLIGTION TN6 AMOUNT 6HOWN IINOER VALl1ATION IS FOR THE
AND 9TATE THAT THE ABOVE �8 GORflEG� AND AGNEE TO COM- pUFP08E OF, ESTAaLIexiNc A PERMIT FEE ONLY.
vLV WITH ALL O INANCEB AND BT �A W6 REOULATING
eu�6ou+o co rn cnoN. ' VALUATION � -_,
81GNATUR O�'�� PERM17 FEE $/ �
PER ITTE Q� Q.p e
OC�/j� $ PLAN CXECi( $ � �_�
AU IZED AGREN a f� •�d � —� �
a TOTAL FEE � y
COSTA
����3�
MESA BUILDING-DEPARTMENT
P.O. BOX 31]
COSTA MESA. GALIFORNIA
'�a� �����E'��b�
AUG � i958
�fd�i�In� nrf3?.
— � �i I.
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
nooaE's"s 3189 Country Club Ilrive BU I LD I NG
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
FECEIPT NO. J�P��[Aj� .
OWNER Newport Homes, Inc. ��j
- RECEIVE� BY OATE RECEIVEO OFTE ISSl1ED
MAIL •, ��' q
ADDRE55
CITY Nt,'4TpOT't BeBCh No: r� E-32z7 ADDRE�ss
ARCHITECT LIC.
oR �EER No. COSTA MESA. CALIFORNIA
FIRE
ADD �( { ZONE
' 11• �1. Boll Cons ��TY L�C. ZONE �/'� � p�qNs TV'E�. GPOVP
CONTRACTOR - ' NO. 1?17 /�
ADDRE55 Newport Beach Np;Nj1 V�3221 BPPROVED DATE
LEGPL LOT 3363 CORRECTIONS
OESCRIPTION NO. �� BLOCK TRACT
A.P. NO.
SIZE NO.OF BLOGS. O
OP LOT �� �� PIOW ON LOT
USE OF ^
EXISTING BLDG.
SETBRCH LINE FROM '
cervien o� sraeE• �� REAR VARD / �
SIDE YARD RIGHT LEFT d
DESCRIPTION OF WORK .
�
NEW X ALTERATION AOOITION
REPAIh MOVING DEMOLiSH
BUILDING ZgO NO.OF / �-
SRE /`,' OJ ROOMS b STORIES
EXTERIOR WALL ROOF '
COVERING StUCCO � COVERING Wd Sh
USE OF NEW dwelling � .
BUILDING
� � r
I HEREBY f�CNNOWLEOGE TNFT I MqVE FEf�D THIS APPLICATION ANO '
$TPTE TXAT THE TBOVE IS CORRECT 4NO AGFEE TO COMPLV W!TX PLL
CITY OROINANCE$ /�ND ST/TE LAWS flEGVLATING BVI(.OING CONSTRVC-
riorv. � VAIUATION ,��_
<�/ �� PERMiT FEE S
PERMATTEE F /Xl I%�� � /�
� PLAN CHECK $
�
�
AUTHORIZED AGENT TOTAL FEE $ .� � „�
err