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1185 DORSET LN - Building Permits
. CITY OF COSTA MESA r5 , • ' BUILDING DIVISION Fj"� . . 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us y i FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER: BC08-00587 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_RRIP DATE ISSUED: 12/23/2008 '-` ->- ISSUED BY: BJK JOB ADDRESS: 1185 DORSET LN CM/' SuitelUnit =, APN: 14114112 Zoning - ,t Vicinity: BEDROOMS -T' Primary Occ 'R-3 ' Const Type: V-B SQ ET 7' 530 •-Valuation:. $55,000.00 V` ` ,, SCOPE OF WORK: 530SF ADDITION TO:'EXPAND BEDROOM/CLOSET#3, EXPAND#4t(MASTER)WITH ADDITION OF A CLOSET, NEW BEDROOM#5 WITH 3/4:BATH& CLOSET TO AN EXISTING 2-STORY SFDELEC: 16 LIGHT FIXTURES, 20 OUTLETS, 11 SWITCHES;,MECH:._1 FAO < 100K BTU, 1 REPAIR%ALT COOLING/HEAT'1-VENT FAN:PLUMBING: 1 GAS UTLET P-TRAP, 1 SHOWER, 1 WASH BASIN;.1 WATER CLOSET, 1;.WATER PIPING:NO WORK TO EXISTING 2ND FLOOR. :.. .. OWNER: BROWN TODD A&JOANNA B v,;_' Address: 1185 DORSET LN r � s I 4:'-t,Unit. Phone: 714 556-0703 1: I • Clly/State/Zip COSTA MESA CA • • • IA? .':1 APPLICANT: BROWN,JOANNA •• • P 'Address ` - Unit : Phone: 714-335-6917 ',-..City/State/zZip: Idj CONTRACTOR: OWNER BUILDER License No:, 000000,; ? Phone: })T •. j Address: Unit: Cell: .., City/State: _!- L 'ZipCode •RCHITECT: License No 5- PHONE ENGINEER: HIEP TRAN t i, License No-C35581,` c. ' PHONE:949-640-1359 COMBINATION PERMITFEE SUMMARY Building Plan Check: -°,$441 19 - _ , , Building l Fees: LCZ" ,',$$ 5 20 _ Electrical Fees: -. , '$75:20 T , ..,:':',1' Mechanical Fees: $59 Plumbing Fees: ' '$78.65„ ."_ SMIP Residential: SMIP Commercial: $0.00 4 TOTAL FEES: $1,338.74 **Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28, §1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE I, INSPECIONTYPE DATE INITIALS _ODEA INSPECTION TYPE DATE IN1111AL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention - 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site r� 204 Final Demolition 250 Final Building/Occupancy J TA i I t WORKERS'COMPENSATION DECLARATIO . • Owner ID verified by drrii�v5rrlEense. Yes 0 No (� >FrP-� ❑ I have and wta maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.•property tax.bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. • ❑ I have and will maintain workers'compensation insurance, as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: : permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure.scaffolding,falsework,cf.demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sector need rot be completed Oho permit is valued at one hundred dollars(3100)or less.) 2,Art 2,Sec. 341,The 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant's Signature Date Division of Industrial Safety Permit Number: Applicant's Signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and _-A•.,; filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature ,Dale',. 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: ;;1' Health and Safety Code been fully complied with? 0 Yes ❑ No I hereby affirm that under penalty,of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE 'LAW, for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:'Ahy city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he ors'he-is licensed pursuant to the provisions of the Contractors License Law'(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). \® I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon;and who does such'work himself or herself or through his or her own 8 (If'yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). - . completion, the owner-builder will have the burden of proving that he or she- _,CERTIFICATE OF COMPLIANCE:-I certify that Under-penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws-and city ordinances regarding Hazardous Materials and Emissions. ' ❑ I, as owner-of the'property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project withCERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives'df Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for insgestion purposes. I agree not to occupy or allow occupancy of any building autholi by this permit until al ins ecti n. / vY q� icfzi - - . ► 2-a3- ftbe �/n I a-,)-3-4 Signature of Legal Owner(s) iDateJ V 'Signature Date • 3057-46(3/07) - Andlor Authorized Applicant Date 40"....9...:44...44.. ff""'Fs CITY OF COSTA MESA '. ) P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 ir 7j Siw 'Y n 0; .� /II a' DEVELOPMENT SERVICES DEPARTMENT NC(1gPONiRE0t. New State Law: Swimming Pool Safety Act of 2006 (Assembly Bill 2977) Effective January 1, 2007 California Health and Safety Code Section 115928 "(d) Whenever a building permit is issued for the remodel or modification of a single family home with an existing swimming pools toddler pool, or spa, the permit shall require that the suction outlet of the existing swimming pool, toddler pool, or spa be upgraded so as to be equipped with an anti-entrapment cover meeting the current standards of the American Society for Testing and Materials (ASTM) or the American Society of Mechanical Engineers (ASME)." 15S \hrSek' 1 rin.t Address/Permit Number Permit Applicant or Contractor's Affidavit (Please check appropriate box): n There is an existing swimming pool, spa, or toddler pool on this property. I will install an anti-entrapment device that conforms to this law, and I understand that the installation of this device is required prior to final building inspection approval. There is no swimming pool, spa, or toddler pool on this property. vd0.r) nG; Bra (On Name (please print) TVYVV\d1 eviaLA Signatu \ /Date Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD(714)754-5244 • www.ci.costa-mesa.ca.us Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. P MIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA CONSTRUCTION PERMIT A.P.# zone • Project Address 8 ©0RSf3% XV /`OSTq /YIIFSA _ 3S�'43 / - C. / 1 / S Main Building: Accessory Building: Applicant's Mailing Address J TYPE OF CONSTRUCTION El NEW UADD ALTERATION ❑ REPAIR E Z Owner's Name Aopv (.0- -1 - DA ea 'Phone 540_JGs1 ❑ CONVERSION ❑ DEMOLISH ❑ OTHE ��. T Front' • O Address I tS DO ? Sri Lam• DESCRI'T IO OF WORK/USE OF B DG. C q St � A R•ear N _ ������ �1' �l C Right . . N Arch/Eng. - License No. TYPE OF P 1'. m R• • - • Si STRUCTU• • K G Address i TENANT ❑ ELECTRICAL .=. PLUMBING ❑ f/�QE(�C�H AANIIC�AjL�' " •j�$ • Left , R Contractor's Name o`� Phone Cr',- e'en^•/ �'I '� �/ ""!�• -yKf��9S14.�Ing. Ref.# - Parking Req./Provided - E • PROJECT DESCRIPTION S0. FT. OCCUPAN Y ft—a • Address(mailing) �� aid eaq Planning Notes: ' Ni • CONSTRUCTION TYPE VALUATION$ T City License No. ZONE GRADING CU.'D5. ACRES • LICENSED CONTRACTOR DECLARATION S. I h-reb affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �) A/_ L// ���•1 with section .. ' '.n 3 of the Business and Professions Code, and n f wsr i "4Y .�( iVT� my licenseis in•full force and e e IIIMMM�+`��� • ELECTRICAL FEES License Class - zo. •3 u��'i3 �( •""'^lV � ••�A �� Date Signature - PLUMBING FEES Automatic Washer Transformer 0 15-50 KW •-- WORKERS'COMPENSATION DECLARATION DOn$trllCtldb Pole Sub. 0 50+ KW ,,.i hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer- Service Sink - Cooking Unit • Meter ❑up to 100 amps -, ' .,..00, Lib. C.) •r "Policy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps Certified copy is hereby furnished. } -�— Dryers ❑Gas ❑Electric Sub Panel A Certified copy is filed with the city Building Division. r Bathtubs Sewer Connection ']_00 ,el Date Applicant I. / /� Motors 261 HP ❑1%-B .--- EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors / Fan -/ / C. OY . (This section need not be completed if the permit is for one hundred ($100) or ' less). Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP 010-15+ I certify that in the performance of the work for which this permit is issued II Fixtures - ' shall not employ any person in any manner so as to become subject to the, Drinking Fountains Solar Tank Microwave Workers' ompensation Laws of California.A/.ill ! _ Date 2 S -if Signature 7�l/�l�S.� Floor Drains • Swimming Pool w/Spa Device Boxes• Pole Light . NOTICE:If,after making this declaration, Itl become subject to the Outlets • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range Q~j - comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION 'LENDING AGENCY. / Switches ign .'1 / I hereby affirm that there is a construction lending agency for the performance- _• Gas •Service Outlets Water Closet ` G • of the work for which this permit is issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections Lender's Name Interceptors ( Water Heater .. • Lender's Address - - • • - Kitchen Sink Water Service Generator 00.5 KW❑5-15 KW y {Trash Compactor .-. OWNER BUILDER DECLARATION • _ �` -- , I hereby affirm that I am exempt from the Contractor's License Law for the i Lavatories - .Auto-Wash - map 4" D I following reason (Section 7031,5 Business and Professional Code: Any city or _ _ . • county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays - any structure, prior to its issuance, also requires the applicant for-such permit ti .w to file a.signed statement-that•he/she is licensed pursuant to the provisions of Roof drains • l,, the Contractor's-License Caw (Chapter 9(commencing with Section 7000).of �jr Division 3 of the'Business and Professions Code) or that he/she is exempt Reinspection Fee- • Reins 4erefrom and the basis for the alleged exemption. Any violation of Section - P $15 L ISSUe Fee fop 031.5 by any applicant for a permit subjects the applicant to a civil ' ' enalty of not more than five hundred dollars ($500). I - - • DEVELOPMENT SERVICES REQUIREMENTS:( • ' I, 'as owner of the property or my employees with wages as their sole 'Reinspection-Fee $15 - Issue Fee $ 3 - ' compensation, will do the work,and the structure is not intended or-offered '- Zoning Approved By Date for sale'(Section 7044, Business and Professional Code: The Contractor's • ,MECHANICAL FEES Building Approved : "toes- for .. Date 9-•Z`—$� License Law does not apply to an owner of a property who builds or improves - - . .. - !i sw thereon, and'who does such work himself/herself-or through his or her own . - Application Issued By - Al"- - Date -�� --yp employees, provided that such improvements are not intended or offered for Boiler , . • Hood or. Type I. ❑. ' sale. If, however, the building or improvement is sold within one year of com- - Canopy Type II 0 MMARV OFE EEL... [Action, the owner.will-have the burden of proving he/she did not build or in- Duct-Under Ground • - ' prove for the purpose of sale). • - BUILDING PERMIT $ L5-7._0o SMIP $ - ! 5-1/ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - • PLAN CHECK • tractors to construct the project (Section 7044,Business and Professions Code: - $ PERMIT • The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ', •_ 00-100,000 BTU ❑100,000 BTU • PLUMBING $ q-00 ISSUANCE $ - ''builds or improves thereon. and who contracts for such oroiects with a con- - - - - - - _. tractor(s) license pursuant to the'Contractor's License Law). I am aware that - % Exhaust System ❑ Multiple 0 System Repair/Alteration • PLAN CHECK 25% $ - ENERGY P.C., $ proof oftheir Worker's Compensx ion insurance should be provided to me. l ELECTRICAL $ 2.2---s-0 GRADING • $ am exempt under Section t ' 'D B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers • ,..-- MICROFILM • $ • PLAN CHECK 50%' $ /� /1� Date f+-Z6 -df Owner - • Heating System& Ducting Registers - • MECHANICAL $ r / ''sem 'TOTAL FEE $ �r ••S� i hereby- certify that I.-have read this application and state that the above ❑6100,000 BTU 0100,000 BTL - - information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and•state laws relating to building construction, and hereby authorize repre- sentatives of this city to a ter upon the above-mentioned property for , Inspection purposes. _ - �" _- • Signature • S* Date Y6-� •Reinspection Fee $15 - Issue Fee $r$ Drivers' octose orss - I Ol 00015353—00015357 TOT 105.50 0865-46,-rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - DATE: 09/26/28 1 At1E: 10:46 ' CONSTRUCTION AND PLANNING • • POOL nA .-n• APPROVALS , Permit# ` Date Inspector APPROVALS Permit# - Date Inspector 1. Temporary Electrical Service or Pole N • 52. Pool-& Equipment Location '11 '- 2. Sail Pipe-Undrgrnd. i `' 53. Steel Reinforcement N i _era 3., Electfical Conduii Utility-Untdrgrnd. v° . -54. FormsJ'' Pl 4. Electrical Conduit Undrgrnd. - 55.''Electrical Bonding • • . t4' 5�j Steell Reinforcement 1 56. Rough Plumbing•&•Pressure Test n, _ °6. Electri al UFER Grnd. 57. APPROVAL TO COVER-GUNITE N `� 1'-} 7!Footmgs - . f 58. Electrical Conduit-Undrgrnd. U ZJ1 F .. 8.�Foun,"daiion d _ C,2I. 59. Gas Pipe, 0 Undrgrnd., Test ,ti °' S I ( 1 9S•Water Pipe-Undrgrnd. f�/J' 60. Backwash Lines, P-Trap, 0 Undrgrnd. . •-.1 vV t0:r Structural Floor System ! 'L '. 7i 61. APPROVAL TO;DECK•,. : - - .t 117 Property Sewer Line & House Con Lection i r t62. Backwash & Receptor-Final ' 1.,Seva'r Cap ` ' - 63. Heater & Vent-Final H 13(Roof Drains • 64. Plumbing System - Final _ f .AiA 14. Rough Plumbing 94-7-0tea65. Electrical-Final - - w - - 15. Rough Electrical-Conduit • ,66. Solar System-Final i(1`6. Rough hlect Ic wiring P- - 67. Fencing & Access Approval v1 Rough <MriIg Sign ' 111 68. APPROVED FOR PLASTERING 1,1V. Roughele'ciriccac-T.Bar Ceilirtg 3 69. POOL/SPA SYSTEMS FINAL ,1 Rough'I�te I•ting Fi Air Conditioning FIRE DEPT. REQUIREMENT • 20: Rough tFadtory1ireplace (.1 '•7 APPROVALS:. Permit# • . '2'1. Ducts, i?Structjre 1 rt , 70. Underground Hydro . 22. Ducts, Vtentilating hi • ki I , 71. Product Piping 0 Gas 0 Oil, 23. Gas.Pipe;F ought& Test 1 _t 72. -Underground Flush 24. Roof F nimg •z '2741-) . 73. Undergrnd.Storage Tank 0 Gas 0 Oil � - 25. Roof Sheathing' ,' t`•T {. I 74. Overhead,Hydro - . . , r26. T-Bartelliiig (S-uctural) &1Alli7jocoat 75. Dry Chemical . . 27. Frame:arid FIas1'dng r-.,J 76. Dry Standpipe . 28( Laping4iSiding I 77. FIXED SYSTEM FINAL . 29: IntiMion Cr,, 7m/A 78. FIRE'PREV. FINAL , 30. Dr'5ttll4FJailing t.' u . HEALTH DEPT. REQUIREMENT Hy_�:.i x ti - . . • 31. Planter Btown Cdat�r r! 79. FINAL INSPECTION 32. Electriva�PoweriiMet r-Final - f.( 80. ,FpOD�CrERTIFICATE ISSUED -�.- i..N •33. Final Electric ' ' #.1,0% v o Notes: - up 34.-Final Heating fAir Conditioning i, • 35. Final Gas Pipe-Test . 36. Hood or Canopy . 37. Final Factory Fireplace ' . . . 38. Final Plumbing - - - •r 39. Water,Service;Final - - - , � - �i' '40. Gas Service-Final . MIA c 41. Solar Domestic-Final 42. Backflow Preventer EXP 1 R E '• C. ' leve 1It✓Pe°tions y -.t 43. Backflow Irrigation InCOmP - ,' tl, 7 44. Landscape Irrigation System 1724,Z SFg �. 45. Sound Attenuation - // .1 S • 46. Handicap Regulations i` i• 47. FINAL STRUCTURE & BUILDING "' 48. Special Requirements Completed • 49. Electric Release to Edison .J 1 50. Gas Release to Southern California Gas Co • .; '7 1" 51. CERTIFICATE OF OCCUPANCY 1.+\ 41 r.t a ,v r. 1 No. Date •1 9 `' v` '✓ i ri - OWNER MANNING, Ray= 'E. DATE 12_2_77 JOB ADDRESS 1185 Dorset Lane BUILDING PERMIT NO. 45156 GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Ree. Room, Interior Alterat: AP No. 141-141-12 LOT TRACT FIRE ZONE VALUES 4.loo.00 IF 'TIONS Signature Dote TYPE V GROUP I ZONE R-1 S. SUBCONTRACTOR PERMITS ISSUED GAS l •Date Number Signature WATER - / PluTj$6I'nra' 'l /� ^1 ROUGH PLUMBING ` ryS / .-O 77 �Y/UGA _ �]JCQ�� !-S- ll /3P IS PROP. SWR. LINE r] HOUSE CON. 0 �^ 0/6 i-J-7/ 789�n i'-'-.SPRINKLING SYSTEM _ / MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE / r- _ - - UNDERGROUND n POWER • �y ��-- G- ROUGH WIRING 4 t r; ' satin• • Vent. r TRENCHES FORMS • STEEL REINF. gi��LLI�/ � ,-Ar)�����ljry�ea�lc, ktele FLOOR SYSTEM 0 �— INIMINleti=_.T BOND BEAM n STEEL REINFORCE n - a. SHEATHING ___.. FRAME AND FLASHI WA :' LATHING - IN i; OUT IR A LfWa�Wa �� it la/S y�S — toli PLASTER. BROWN COAT iit3,: • I d (iR UMW I STRUCTURAL, FINAL42.3i ��- I �\tiNM� r R H 9 I 1 G. VENT., REFRIG. AND A.C., PINAL „ yO 1-10---31 r rs ��, leis illiCKEgid�a_ A_� F .ING, FINAL AND GAS TEST n J �O 1 li���J-ra iyi�yr� �,-f. _ _ 1 ELECTRIC, FINAL /�C I-� COr1W+mallI:.:a_�--t�•l�OV11�7L�1�1 - _ BUILDING, FINAL y!= 4.22.SI 1t4;"� �tea.1:77,41:i'L 1l-.. • i 451 6 DEC -2-77cisD00 122* ****1181.50 ..: COSTA MESA BUILPING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A'f' A ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only REr'I ED V DATE RECEIVED D•TE ISSUED BUILDING A / f . ADDRESS O II. .d .` �/:�- �/7 �N-p/- OWNER �O��L.v E. Mr4Clnl /Ai? BUILDING ('t 7JV'_ ,/ MAIL /6'S 4o_$ 1 Clef ADDRESS /�!� ,J ,. C. G /u%- ADDRESS TEL. Z r¢ ' TRACT 9'37 LOTS9. BLOCK CITY Coat4 ,-,- 5A NO. Sys=6916 CONSTRUCTION r.� NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER Sc& " fr • BRANCH OW N E R �C4//QCO ' F_ 0,414r • ^ &Weir ADDRESS f&Ca n�a'F VALUE 4`/ iyi. ARCHITECT / TEL. USE /Mr $ OR ENGINEER SCL NO. FIRE ADDRESS 54-,'nt *s /}' 'gAr,`�.,lG _ ZONE LYPE GROUP 21.....7. maty AP CONTRACTOR ea'C L . 7 JKN BVPROV ED DA • s'1, �7 ADDRESS ----------- TEL. ZONE / NO.OF USE OF NEW44110rt' Rig CITY "� NO. A-t PLANS BUILDING/SaabMot o--1 STATE . CITY YARDS APPROVED YARDS APPROVED LIC. NO. .LIC. NO. . MAIN BUILDING ACCESSORY BUILDING Ba SIZE . NO.OF BLDGS. (FROMJ[C{/La�gT/g/EET'1/ 1_� �/n a. OF LOT G,n'W x /On' (] NOW ON LOT / FRONT/T!/V R,TL(��r fir/.f�[C�B/"C. • Q USE OF �) MS,'DE- ��/y eep".6 2 ecra4 t cn p-IEXISTING BLDG. /'rO�s4E FL FT. 0 Y'WQMGt �- F Separate permits are required for L.SIDE FT. /N�• 4! FT.�� d electric,plumbing and heating work. 4a _4� ve PG AF,� 1 USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS.BLOCS. 6 None QEC• l en. CUP - 22t2 APPROVED/A/44 77 7 APPROVE( '+t/ ,Z /2-.2-72 a —Y DATE CC W a 0I hereby acknowledge that I have read this application and state . n r. I> that the above information is correct and agree to comply with yco all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of m L" the State of California. [—//}/�,'�� - 3 I hereby certify that I am properly licensed as a contractor under l.J `� SQ.FT. d the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR w Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business ,S • to VALUATION PERMIT FEE $ L a and Professions Code, Division 3,Chapter 9. ,n m r� PLAN CHECK $ n Signature of ' / Q1) o Signature /fPi€2-., s/`-/ $ T/o' TAX $ I/69 TAX D . Authorized Agent TOTAL PAID $ LO 34 TRACT 4395 FEE RECEIVED ` 16309 JAN 3 11962 dOSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. 0. BOX 317 COSTA MESA, CALIFORNIA' CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ADDRESS //g5 Doiset zan COSTA MESA. CALIFORNIA For Office Use Only RECEIPT NO. I PERMIT OWNER 'K R K OFV FI OPM FNT CO., INC_ MAIL RES_ED BY DA H eD QMEHBBUi�[�f ADDRESS 1555 PLACENT IA AVENUE L.,� C/ 7„[y�"-E;4 J n J 1 aL CITY NEWPORT BEACH TT I 63227 LDING ADDRESS A ' ECT TEL. COSTA MESA. CALIFORNIA O (NEER NONE NO. AD SS FIRE I/ ZONE TYPE Y GROUP • CONTRACTOR K. W. KoLL APPROVED BY DATE ADDRESS 1555 Pi A CENT IA AVENUE ZONING O� cin' NEWPORT BEACH ZONE / I NO.OZ I USE OF NEW %= -7✓ .I-. [ PLANS BUILDING 'au7OJ�'� LIC.STATENO. 01195 No. M I . 6-3227 LEGAL Lo](' 3 `� 74' `13 9S DESCRIPTION OF LOT 40 ISIZE --/--/DO / I NOW ON LOTS O A.P.NO USE OF YARDS EVES EXISTING BLDG. NONE APPROVED ALLOWED SETBACK LINE FROM nr7 ' (CENTER LINE BT.) CENTER OF STREET v .0. , REAR YARD � FRONT SO FT. IN. SIOE YARD I LEFT f I RIGHT cc/ R.SIDE S FT. IN. DESCRIPTION OF WORK L.SIDE �-S FT. -- N. N I X I ALTERATION I II ADDITION I REAR ` FT. 7 IN. REPAIR I II MOVING I II DEMOLISH I APPROVEDBY 0-1,41/ //30 6 i LqJ /,:/r� /_t NO. OF BUI7 /P.S� DATE SIZE Cjy,� y ic.5" Ai ROOMS STORIES 1 p1 EXTERIOR WALL ROOF Loc /P /,' COVERING STUCCO I COVERING /1717e/ C. USE OF BUILDING AND WORK TO BE PERFORMED-- SIN,I E FAM 11 Y RESIDENCE WITH n "� � ATTACHED GAA?RAGppE . v , J PIAN # Z' /11I//I7 , I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION (� SIGNATURE OF l � !' Z/ jc ' v/- PERMIT FEE $ -9f-- PERM — N PERMITTEE /'y) �C o'✓`� Y m . $ PLAN CHECK $ — 011: AUTHORIZED AGENT L E TOTAL FEE $ ') 2 II t • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT j - P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 t • RECEIy9�V IPERM T For Applicant to Fill in Completely—Use Ink Only /t Cil. 52? �/ 7 81 10 OU TL BUILDING IN A.P.NO. ,y/- ADDRESS /VSs Da,a2 CT /9/ �f—//^ J\/^z.t/`, 1 BUILDING //F7 ///�/�.,,�Cr�1 OWNER OR ADDRESS GC/ TENANT ®�/� ��� 'E n'J�riI hJIN� UNIT OR . MAILING ,, SPACE NO. ADDRESS //t� Oen_Se: //r (yy. TR.NO. LOT SLK. TEL. ( / CITY Fc rA /J•IE�y� NOs7j-(,.9/G • NEW ADD ALTER REPAIR MOVING DEMOLISH ' CONSTRUCTION cl- BRANCH LENDER ��r� ---A,OWNER //// N/,Ln / f-`Aibik ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER NO /�l ADDRESS ZONE hi—/ [TYPE V�. SOUP /)o' ,l /J APPROVED CONTRACTOR eflie ie-/e eac pC/z— BY s DATE• / ADDRESS r /�f 17 TEL. &Vast ``r�Ows✓ CITY TE •�1. F STATE CITY APPROV ETBACKS gLIC.NO. f LIC.NO. W SIZE NO.OF SLOGS. (FROM C/L STREET) O. OF LOT NOW ON LOT - FRONT FT. Q • USE OF � EXISTING BLDG. R.SIDE FT. CC FSeparate permits are required for L.SIDE FT. - C electric,plumbing and heating work: REAR FT. H USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q . DATE dentioapp: APPROVED APPROVED ›. ABY • DATE ..1 CL Q • I hereby acknowledge that I have read this application and state cn C4 that the above information is correct and agree to comply with _ 0-. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of 2 •..W' the State of California. ai- I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR to Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business e VALUATION and Professions Code, Division 3,Chapter 9. PERMIT FEE $AO — ,e m PLAN CHECK $ rn Signature of / • ��_ o Permit-tee L TAX $eeG / / % $ or — / f U Authorized Agent Date TOTAL PAID $ / r