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Home My WebLink About1768 CRESTMONT PL - Building Permits - CITY OF COSTA MESA 4, ► BUILDING DIVISION Ij:J,,,,,, ,r, �� DEVELOPMENT SERVICES DEPARTMENT PER NUMBER is t f PERMIT fi: P05-01041 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.cLUMRING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1768 CRESTMONT PL Status: ISSUED Suite No Applied: 12/30/2005 Issued: 12/30/2005 Vicinity: Parcel Nunmber: 42426207 Applicant: PAULEY, SHANNON ISSUED BY: 474 .41 Address: 17390 MT CLIFFWOOD // Phone: 714-241-1414 FOUNTAIN VALLEY Zip: 92708 Owner: WEAVER, BILLY W Address 1768 CRESTMONT PL Phone: COSTA MESA,CA Zip: 92627-3620 Contractor: COAST ROOTER PLUMBING HTG AND AC R R I P Address: 17390 MT CLIFFWOOD Phone: 714-241-1414 FOUNTAIN VALLEY Zip: 92708 License: 529127 SCOPE OF PERMIT WATER HEATER CHANGE-OUT IN AN SFD. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. • FEE SUMMARY AMT QTY AMT QTY AMT QTY ' ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P_Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 0 - -Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) , $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS I SPECIAL CONDITIONS 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: This permit shall 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 and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(6/00) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ .1 have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the r work for which this permit is issued. ,61I 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 permit is issued. ' My works/r ccompo ation Insurance career d policy number are: �j/ C/ ' / Corner:_ (�1 CM� �i(9 Pot •Number. )76:"`+' o SO - �C>D (This section need not be completed i/the pe Is valued et one hundred dollars($100)or less.) V ` ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C:'• - agree that if I should bec•••. :at to the workers'compensation provisions of Section 3700 of the Labor Code,I shell forthwith comply with these Line i c Applicant Slgnetur:•• � % Date:—_-'> /t- - 3 U ' OJ WARNING:FAILU' RS'COMPENSA y, •VERAGE IS CLeriA AND SHALL SUBJECT AN EMPLOYER CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND p• . If,u•),IN ADDITION TOTHE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTIONmw OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am license u rovlsion-s-rof Chapter 9(commencing with Section 7000)of Division 3 of the Business and fessi s ccode,and my license is in full force and effect:hc.pr t §'t1�A'� e / Class# '• - 3 i "Conbacto[s Signature__ �/ .----C-, _...S2-- C _ Date:•— /Z O ' o S CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered 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,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.It,however,the building or improvement is sold within 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 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 property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of documen,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title B,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. • Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions.that a Business Plan be tiled with the Costa Mesa Fire 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 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑No (Section 25533 of the Califomia 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 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 temperature end pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. W 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied w ? ❑Yes 0 No ith 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes ❑No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If yes".the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast'Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). - CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:1 certify under penalty of perjury that 1 have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described prope • . nspectio purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Si.-' +i .gal Own= - Date i ".Or Au oozed / (_Date--'r QQnLL. INSPECTION TYPE PATE UiThlAiS COOEff INSPECT1ON TYPE p1F INTmAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ' IR---0-67 - 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 204 Final Demolition 250 Final Building/Occupancy 9• Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -, 129 2/ 10/86 �0� I L CITY OF COSTA MESA� CO $TR Uy) ONMITA, PE 51: O. TRACT NO. LOT NO. UNIT NO. Project Address /F-1 �yiyi�/t0177` PI • /{/ .0 70 n • �� Applicant's Mailin•A•dresss • �� / _ 4 $L • TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION k REPAIR I r Phone i I 1/ , ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone lle3 Owner's Name ,f I DESCRIPT ION,OF WORK/USE OF BLDG. I J Address �L J S Main Building: Accessory Building: E Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION U STRUCTURAL T Front O r Address - nn ,/rte ❑ TENANT ❑ ELECTRICAL , PLUMBING ❑ MECHANICAL B Rear - N 1\/~•,f' Contractor's Nam III - .. 4•ti. , a- Phonel> QD�1 El OTHER"' C Right N Address(mailing) (d fie") to PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G 7 7 CONSTRUCTION TYPE VALUATION$ R I City License No. 00 67 - ZONE GRADING CU.YDS. ACRES }• LICENSED CONTRACTOR DECLARATION Ping.ng. Ref.# y (�Parkinpgg Req./']Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: KECEIVELI I- L B 3 r Q COth section 7000) of Division 3 of the Business and Professions Code, and r••�•U M `` J my license Is in fu) ora4 nd effect. --n T License C as �•hr��h f• it-n • • t, S Date y it gnature IMtM ! ' .r"ar PLUMBING FEES • WORKERS'COMPENSATION DECLARATION Bar Sink Showers i hereby affirm that I have a certificate of consent to self-insure or a certificateELECTRICAL FEES ,f Workers' Compensation Insurance, or a certified copy th reof (Section Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW - 3800, Lab.`Ct�)/'t ( [�/�//` Policy No. V1U/IP�/�D Company -7\ v u/G Backf low Irrigation Sewer Cap tr ion Pole Sub. • 0 50+KW edified copy is hereby furnished. C E�i-'I'�'C"-er]j1I i�rh{3py itnd with the city v' oym///.nom/� Bathtubs Sewer Connection ' - ing Unit Meter ❑up to 100 amps Date // V_ "' Applicant gr > �r�l'C�v✓�N't EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). DishwasherSolar Piping ^..,s,C��. •�J _'•� Dryers ❑Gas ❑Electric Sub Panel I certify that In the performance of the work for which this permit is issued I CF { -shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank 7/ `_ Fan Motors 00-1 HP ❑1'h-8 Workers' Compensation Laws of California. - . Date Signature Floor Drains Swimming cape F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ 'NOTICE:Compensation makingthis of declaration, you shouldCode,becomesubject h it¢ comply Com such 1pn provisionsior of she tr you et forthwith h FIOOr Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet I hereby affirm that there is a construction lending agency for the performance Device Boxes Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors ' Water Heater N CO Outlets Range Lender's Name - Lender's Address Kitchen Sink Water Service - Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's-License Law for the Lavatories Auto-Wash . Garbage Disposal ;Standing Sections 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 Generator 00.5 KW 05-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains en -the Contractor's License Law (Chapter 9(commencing with Section 7000) of "Division 3 of the Business and Professions Code) or that he/she is exempt .9therefrom and the basis for the alleged exemption. Any violation of Section --7031.5 by any applicant for a permit subjects the applicant to a civil - 'penalty of not more than five hundred dollars($500).. / I • Li I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 / e $ 3 compensation, will do the work,and the structure is not intended or offered •- Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECEIA1Q1 AL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Zoning Approved By -_ -- • Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ /'� prove for, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By - /-�a Date !• prove the purpose of sale). • 0\vi) c-./D y0 ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Applic tion Issued By s Date 7 -JI tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU - SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLANCHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers LUMBI NG $ J�On ISSUANCE $ Date Owner Heating System& Ducting Registers • PLAN CHECK 25% $ ENERGY P.C. $ _ I hereby certify that I have read this application and state that the above ❑0.100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for - inspection o �i / 7 �� MECHANICAL $ TOTAL FEE $ �0 Signature in `'Date/7% Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS# - - • , _ CMF 0865-46,rev. 10/84 white - Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL& SPA i APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1: Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. .Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd- 60. Backwash Lines,P-Trap, O Undrgrnd. 1.0. 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 Electrical-Conduit 66. Solar System-Final 16.- Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:6,_-7-f1 &yv.4Z' r 710 34. Final Heating & Air Conditioning ' a iK 35. Final Gas Pipe-Test nit .2° ' L/J�y 36. Hood or Canopy !^tel �,2,1/1/ -_4 e/tri " - 37. Final Factory Fireplace 38. Final Plumbing .. 39. Water Service-Final ta- 40. Gas Service-Final Tr: 41. Solar Domestic-Final frli 42. Backflow Preventer • , 43. Backflow Irrigation 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE &BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date OWNER AYERS A.W. APR ici DATE -2 - • _ JOB ADDRESS 1768 CreSont Place tinBUILDING PERMIT NO. 9078 GENERAL CONTRACTOR A.W. Ayers VALUE $ 10,6111.00 AP4c-181-0(LOTTRACT FIRE ZONE DESCRIPTION OF WORK Residence WVgarage GROUP TYPE V ZONE R4 PLAN NO. 9078 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER I Trenchei ,A4LForms v Steel S-1/2/S-5 Floor System Ci 6 IL S ii-ft • Steel Reinforce Chimney Re-Rod r-Brmd-Boma- • " - i'j ci [-4 -c? Frame and Flashing " Cgi 1 i/r y/ri • Lathing, In Ws' Out 9 G//AJS'`1 Plaster, brown coat 9 -//-t`'' Underground soil/0.4 S W/G Pipe Test/ht S-_I c_a-, 'fr/ Top Out S-'ll-sti II u 5-29 .S4 � I, Furnace /WS - a C144-0, 5 , :-) br-67 /cit . 1' l °! Gas Vents _ y /i Rough Plumbing L ty 6'9-.59 2Q , n /j,/�,r7.� _ ---_9._69 ill.-7 _, �/ Cesspool Septic Tank / 1 Prop. Swr. Li - Ho re: on. St. Swr. 7 1 y-:y agne J Sprinkling System Heating Final a' Q=I&,.Q'9 Plumbing Fixtures, Final . Tt..An Final Gas Test /Effl.L &Q./tin Construction Pole - ✓72.7e./mac,.- C' S , Cie' SJ,.:7).-5 % 9078 ��EE RECEIVED • CQSTA MESA BUILDING-SAFETY DEPARTMENT LI -� -51 \ `--. P.O.BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT. ESA FOR APPLICANT TO FILL IN COMPLETELY APPLICATION OFORMPERMIT TYPE OR PRINT BUILDING ID ADRESSG /7�razt... �/iCiC�/,/JGIQ COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PbERMIT�NJO.(•/ OWNER I / /" X MAIL r RECEIVED BY 1 WE RECEIVED_a DAT ISSUED ADDRESS 141.11/�....•10._-.i 4.-.;-:,279 4--.1-7 T 37 • TEL. a• LDING ILP . ' .! _ N• / IMP.DDRESS _ - ARCHITECT '- LIC. OR ENGIN R �. NO. COSTA MESA,gr oup. LIFO RNIA ADDRES ` SII' ��ZE *'✓Y`- '/ tY ouP (/�J I .." ♦. - e� / ,w� ZONE !/ / . / 1� CONTRALTO- ' �� STATE APPROVED '/�- , / / //Lr LIC. BY DATE �aN -S LEGAL ? la� •N ING r7 ZONgJJ17/ NO.OF USE OF NEW DESCRIPTION I/NO. BLOCK TRACT 7\ (PLANS //��7 ( BUILDING � ] I A.P.NO. 1/�( L. / [ - BYPROV E�/I� I Ilh J^/LfL� DATE✓�///lll...l�/lam/ SIZE /',/y ./ /0 NOOF BLDTJ U YARDS •V Y`L'- . -EVES OF LOT /V'^ (/ ,l• Z NOW ON LOT!l REQUIRED ALLOWED USE OF (CENTER LINE ST.) EXISTING BLDG. FRONT .,OTC) FT. 1 IN. . SETBACK LINE FROM tOA 4:74 n//p II CENTER OF STREET :a3(WA( '/ REAR YARD,XC�.} R.SIDE •LFT. IN. SIDE YARD LEFT / RIGHT 5/ L.SIDE �)�. FT. SIN. DESCRIPTION OF WORK REAR -J-/iT FT. I( IN. - NEW In II ALTERATION V ADDITION I REPAIR I V MOVING I V DEMOLISH I BUILDING ie., 9.5 5 NO.OF SIZE '/j/ lJ ROOMS STORIES EXTERIOR WALROOF COVERING �• 1OVERIN USE OF BUI ING AND WORK TO BE ORMED / / N=L-�—��. /O 3S 7S , :1 -?6a' I HE-EBY ACKN•"LEOGE AT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VnUATION IS FOR THE AND STATE THAT THE AB•VE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING -. BUILDING CONSTRUCTIO VALUATION SIGNATURE OF 1!"`Lam,^ PERMIT FEE $ PERMITTEE $ I& //cq. PLAN CHECK $ /•f AUTHORIZED AGENT ( f!/ / TOTAL FEE S 3!l��T OWNER CURRY, Earl S. DATE 1-20-65 — JOB ADDRESS 1768 Crestmont Place BUILDING PERMIT NO. 23435 GENERAL CONTRACTOR Damis Constr. Co. DESCRIPTION OF WORK Fire Dameage Repair Al' No.116-181-07 LOT TRACT FIRE ZONE VALUE $ 4,000.00 INSPECTIONS Signature Date GROUP I TYPE V ZONE R-2 Soil SUBCONTRACTOR I PERMITS ISSUED Gas Date I Number I Signal • Water Plumbing Rough Plumbing Prop. Swr. Line 0 House Con.0 Sprinkling System Miscellaneous /� Rough Heating and Air Conditioning j7.4' t/39,4- Temporary Service or Pole Underground 0 Power 0 Rough Wiring 4 j /•)l<S''' Heating and Vent. Trenches 0 Forms 0 Steel Reinf. 0 Wi/C.,„,„ 07,7.. //.�7 /S• 37. S—i '>Floor System �p�G.� • i Bond Beam 0 Steel Reinforce 0 Sheathing fr*L) //2-01.2-' Frame and Flashing,_ y.�, 4 ( /Cr Lathing — In • Out.0 /�/i 9`4.) . Plaster, Brown Coat • Structural, Final ///�� Electric?....2.,... . p� Heating, Vent., Refrig. and A.C., Final de, "Ara- _A,,,� IY'c- . //2. o/dl'. 3 FCC. a Plumbing, Final and Gas Test 0 "Ara- Electric, Final H/51 rir .f/4. - - - - -- Building, Final / k'' Special Requirements Irina,/ Nnfi l„a c,„ Ck t'lnnt ... . .J/.a/r^ 1-1._ IILULi v LU .. 23435 AN 2 0 1965 CpSTA MESA BUILDING-SAFETY DEPARTMENT I ANCE DEPT:' ' / P.O.BOX DIT COSTA MESA,CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING /6 P For Office Use Only ADDRESS / 7 - CrtSr mcn r- Pl RECEIPT NO. M O. COSTA MESA, CALIFORNIA RECEIVE , 1 !- �(, �;�N OWNER A r I - SI i _ore // r� �/ ADDRESS / 7 6 it- CY GS TNn0,,r Pi. ADDRMAIL BU I ESS NG I 76 Lyn rA4,� f . . FIRE r /I,/ TEL. CID' 32�t ZONE TYPE y GROUP CITY CO S r'Q MzS A NO. 6y�'.�/B G ARCHITECT - TEL. BYPROV,EYJ�� 1&• �^.}t ( T / i� OR ENGINEER NO. 5-113 / Or a ZONI4G t , L ADDRESS _ ty Con C 5 N1< I POOP I USE( NE �• O) PLANS0 BUILDING 4` CONTRACTOR DA Hr/S OHf/1 O . `/�\ rr '/ LEGAL / i/ • •I ADDRESS 31•/- PAc. Ac' t0 AI 4' Argy DEscRIPTiON CITY Goy9 QeALA A.P.NO. •♦ - (/ G NOTE: NO EAVE OVERHANG SHALL BE LES HAN STATE 2!339 Y NO. a �7 -3aQO' SO'TO SIDE B REAR P.L. LIC. E EAVES S1ZE I NO.OF BLOBS. /a ALLOWED (U.B.C.REQUIREMENT) OF LOT NOWONLOT \ YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. (FROM C/L STREET/ SETBACK LINE FROM FRONT FT. FT. CENTER OF STREET REAR YARD SIDE YARD I LEFT cf, I RIGHT R.SIDE FT. DESCRIPTION OF WORK L.SIDE Fr. FT. • NEW ALTERATION ADDITION REAR FT. FT. DISTANCE BET. . BET.MAIN& �� MAIN BLDGS. ACCESS.BLDGS. REPAIR {� MOVING- DEMOLISH VAR.# DATE BUILDING • NO.OF SIZE ROOMS STORIES // C.U.P.QL / q APPROVED " EXTERIOR WALy._, _ I ROOF �` APPROVED ' /I // 1 0 '/_ COVERING "/C/CC COVERING /.Y(�ca' BY W, a/ /Q ATE 1 ' &i USE OF BUILDING AND WORK TO BE PERFORMED J 1/� I �CPA-6 Plc? D,4�Hs-0 • pg4 J90/ ti, Q,r N SO.PT. G 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 OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES ND STATE LAWS REGULATING VALUATION u BUILDING CONSTRUCTION. T� l ;Oa H SIGNATURE OF I'/' !�._=/ - PERMIT FEE $ /:, F PERMITTEF AAuu./V $ PLAN CHECK $ 7 r E AUTHORIZED AGENT TOTAL FEE $ J u