HomeMy WebLinkAbout3261 DAKOTA AVE - Building PermitsJob Atldress:
Suite:
Vicinity:
Primary Occ:
Parcel Number:
3261 DAKOTA AV
ROOF
R
13906624
app�icant: YOLANDA HUAPAYA
Atldress: 10522 BRIER LN
Owner:
Address
CoNractor:�
Add�ess:_
� Zip:
, �
Arch :
,Address: _
Z�P
Type of Construction: V-N
Zoning:
TUSTIN, CA �- ', �%�; ';�
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ONTKO, MICHAEUEDWARD'
3261 DAKOTAAVE �
. �t
.COSTA MESA, CA '� � . � -
MC CORMACK ROOFING �`
4D91 E !A PALh9A . -
SUITE D ' � ��: � ='�
ANAHEIM; CA �
92807 '
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Phone:
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c�License:_
_- ;
. , _ . _. Status: ISSUED
Applied: 11292005
Issued: 11/29R005
, �- BFione:-:714393-6251 ISSUEDBY:
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Phone: 714-630-5543 i �
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�Licenae: 643700 � i .�
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Address:
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` � SCOPE OF PERMIT _ • ' i
TEAR OFF EXISTING ROOF. INSTALL�I�LAYER OF 30k FELT, 30 YEAR COMPOSITION SHINGLES_AND REPAIR/REPLACE �SHEATHING AS �
NEEDED. 22 SQUARES. � .. . . - . -. � . � -� � � ;
. - .- ,. � . ,,. ,
- � � �FEESUMMARY��- � ` �
Plan Check: ' $0.00 Calc Valuation: ' ' s5; oo.00
Permit " $125.25 ' Claim Valuation: - $s,�oo.00
SMIP Res:'� � $0.51 ' " v'�; 'i � ' r
, �, - �, .�` . i _ , J ,
,SMIP Com: $0.00 ; - -: - - _ ' � y,; � ; -- ,
�, Other. ' ��, $0.00 � _"_ � /,,� ; , �
Inspection: $0.00 , � .. ' " ' ,
� - :-r. •----- — • - � '
Total: �$125.76 '�� �,
. ,
� PLANNING & ZONING - ' '
i% � J� i
SETBACKS . ; �� �.-; -,,,_ �% ,;��.� , • �� %i �r' '"� /
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MAINSTRUCTURE Front � 0'0,�� Rear �0 0', �. � Lefl 0 0 ` RighJ /0 0 ' �
a i� )�
ACCESSORY �� Front. 0;0 ���;Re r. 0-,0�� � ° Left. 0=0 , _� �RigFt 0-0���� � j
_ ' � .. � - , ' - . ��". ' � ', :
PARKING E ixslina. �'0 �Reauired: 0 Pr000sed:r 0�
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NOTICE: The work authorized by ihis permit shall compty with all applicable handlcap access �equirements under Califomia statutes end related
regulations. (Ord. No. 9248, § 1. 12-21-92) �_�:.��Tm �_-_ --. --
EXPIRATION: This permit shall automatically expire antl beCome void II work Is not commenced within 1B0 days, or it work is suspended or ebandonetl
tor e period of 180 days.
INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with ell epplicable codes, and all
requlred Inspeetlone and Ilnel epproval must be obtained. Feilure to obtain Inspections and final approvel will rasult in the expiration ol this permit.
FOR INSPECTIONS CALL: (714) 7545628
[Mo-w Io'u+i
WOFKERS'COMPENSATON DECLARAnON: ' 1�
I hereby eNirtn under penalry oi perjury one oi Iha IWlowing dedardtions ' . � , � �
❑ I have entl will maintain e cenificate of consent to sell-Insure tor workers' compensation, es provitled lor by section 3700 of Ihe Labor Code, lor Ihe peAormance of Ihe
work tor which lhis permit Is issuetl.
� hav nd will maintaln workers' campensation insurence, es requiretl by section 3700 of the Labor Cotle, for ihe peAortnence of the w rk for which Nis rmit I5lssueE.
My e s' compa� j j Insur n wrtier entl po n�m r a e: �/1! y� �%
camer:'�?'-� �� a� �) Y I 1( � PolicrNumber I`� ���
(71(is secnan need nof be comple(ed i! e rmrt !s velue at ane hundred dollers ( ) or IessJ
❑ I cortify Ihet in Ihe pertorme e ot the wark lor whic� this permit is luued, I shell not employ eny person in any menner so es to become subieit to the workare'
compenselion law I Calif r ie, an egrea h if I should become sub�ect to lhe workers' compensetlon provlslons ol Soction333 700 of th Lebor Catle, I ahell torthwlth
comply with th Hsio 1, 1� � O��
Applicept SlpnaWre: - Dete: _ _ 1
Y/ARMN(3: FAILAIFE T SECUH WORKERS' COMPENSATIIXJ C �M IS UWFUL AND SHALL SUBIECT AMEMPLOYER TO CRIMINAL PE ES AND NL FlNES UP TO ONE HUNDRED
�TF1IXI5lWDOOLLARE 100,000�, ADDITIONTOTMECQSTOF P SA UAM4GE50.SPROl�OEDWRIN6ECf10N3)pgpFiNEUBORCODE,INfEREST,ANDATTORNEV'SFEES.
LICENSED
❑ I heroby aflirm
Lenders Neme:
Signature: _
UECLARA710N:
n r ' I o hepter 9(commencinp wlih Section 7000) of DiWsion 3 of Ihe Bu s���.��/�p rofess' CoAe, end my license La in tull
�—C—Ies��SM �.,•J l'� �
rl e,e � �
(1GENCV:
i is e construciion lending egency for th ormence at Ihe work for which this permit Is Issuetl. (Sec. 3097, Civil Cotle).
Lentler s ACdress:
Dale:
OWNEH-BUILOER DECLARATIONS:
I here6y efllrm t�et under penelry ol perjury that I am EXEMPT FROM THE CONTtiAC70RS LICENSE LAW lor ihe tollowing reeson (Sec. 7031.5, Busineu and Protessions
Cotle: Any dry or counry which requires a permii to consiruct, elter, imprwe, OemWish, or repair eny siructure, pnor to its issuance, elso requires Ihe eppliwnt tor such permit
to file a signetl statemeni that he or she Is Iicensetl pursuant to Iha provlsions ol the Comrectors License Law (Chepter 9(commenUng with Seclion 7000) ol Dlvision 3 ot Ne
Businass entl Profeuions CoGe) or thal he or she is exempl t�erelrwn end the basis tor the elleged e:emption. Any violation oi Section 7037.5 by eny epplicant for e pertnit
subjecls the epplicanllo a civil penalry of rrol more than tive �undretl ddlars (5500).): �
❑ I, as owner oi the properry, ar rm� employees with wages es Iheir sole compensa�lon, WILL 00 TME WORK, anO ihe siructure is not intended or oHeretl tor sale (Sec.
7044, Business and Professions GoUe: The Contractors lJcense Lew does not appty to an owner ol property who builds or improves t�ereon, and w�o tloes such work
himseN or hersetl or thmugh his or her own employees, proNOed ihet such improvements are not Intended or oNered for sale. H, however, iha building or Imprwement is
sold within one year of completion, ihe owneo-builder will have t�e burden of proving that he or she did not builtl or improve lor puryose ot saleJ. �
❑ I, es owner ol lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business and Profession5
Code: The coniractors License Law tloes noi appy to en owner of pro0eny who builtls or Impmves Ihereon, antl who contracts for such pmject with a conirector(s)
license pursuant Io t�e Conlraaors License Laws.).
❑ I am exempt under sec. Business end Professions Code for ihis reeson:
Signature: Data:
Ownar ID veAfied by driver's license. ❑ Yes ❑ No Dnvers Licanse No.
Verilicetion at Ownership by (type ol document, I.e. - proparty tax 6ill or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFICATON:
Expires:
❑ I hereby cenity Ihat no axcavation five (5) or more leet in deplh Into which e person Is required to descend, will be metle In connection with work authorizetl by this
permi�, end that no building structure, scattdding, lalsework, or demolilion or dismantling thereoi, will be more Ihan thirry-si: (36) feet high. (C�ep. 3.2, Grp 2, An 2, Sec.
341, Tltle B, Celilomle AdminiSlralNe Cotle).
❑ As owner-builder, I will not amploy anyana to tlo work w�ich would require e pertnit Irom the Division ol lndusirial Seley, es notetl a6ova, unless such peraon has e
permit to tlo suc� work tmm ihe division.
Siqnature: Date:
Divi9ion ol IntluSlrial Sefety Permit Number:
CERTIFlCATE OF COMPLIANCE ANo AIIfHOR¢A710N OF ENTRY: I cenify under penalry of perjury that 1 have read lhis aOPliwtion and state that the intormation given is
correct. I agree to wmpty with ali state laws end ciry orAlnances relating ro building conswction, and auNodze representatives ot ihe Ciry ol Coste Mese to enter upon the
ebove�tlescribed propeny tor inspection purposes. I egree noi to occupy or ellow occupenty ol any building euthorized by t�is Dermit un�il final inspection.
1616 vFixetl System Final Fire Prevention
1266 Pool Spe Final
200 Final Ro-Rool
201 Final 81ocWRetaining Well
202
203
204
Final Fectory Fire Place
Finel Sign
Finel Domolllion
COOE 1 ' INSFECTION TYVE
206 Final Mec�enical
208 Final Plumbing
210 Finel Eleclrical
212 Final Flre Preventlon
220 Final Plenning Approval
222 Final Site
250 Finel Builtling/Occupenty
nooxessaem�nuu: 3261 DAiCOTA AV
avxL.°"wEi��a� ONTKO, DIANA S TR
���% 3261 DAKOTA
COSTA MESA,CA
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APCN.ON FNO.'8 AOOPES3:
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FLOOD: X
92626
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CITY OF COSTA MESA - BUILDTNG PEAMIT
37 PERM NO: B 086634
PERMIT NO: B 086634 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : TEAR OFF 6 INSTALL CAP SHEET HOT MOPPED SQ FT: 1,976
CLAIM VALUE: 1,976.00 CALC-VALUE: 1,976.00 GROUP OCC: R-3 /
���T�'g� CRANF( BROS ROOFING CO ( 714 ) 548-5569
cwm�croirs�uiwn 126 COMMERCIAL WAY
�oa+ESg.COSTA MESA CA ��= 408677
92627 uNT:
LICENSED LOHtflARONS DEClAN1T10N: I Asab/ elfnn utlr p«Wy d pajuy tM I mn Ocwuetl ivqx pwmoru d Cheqa B
(ownm«+av w'vn Secrbn �oOO) d Drvum J al me Businw ad Pm1aa'vs Cm�. ena mY uoenro e in tuo wu rd enaa.
�uc.No.:005993 uc. s:C39 uc"jg �6�EX� /98
�— /� r camwtr: _[ i � �/(� r
OWNEN 9UIl0EF DECLAHATION: I Mmby efFrm uAlx peW y d parjvy Ihet 1 am a+anq Imn tM WMreqars lirome lew la ihe
Idbw'vq ieefan (5otlion )OJ1.5 &wiiwa eM Ads�adu Code: MV uY a awMY xtiitli nW'vet e W�i lo mtnWCY. Ms.'vnpova.
Eemd'wh, a rpei ury si�u�Yu�e: Rcr io u ea�aca, ebo nQu'vm 1he epWiraN lar euch pamil io fib e eqneE stntement Wt he or ehe
ia licenud Wnuant lo �he provniona ol tha Canlreqoy ���� �w jCheqm B(�me�a�p wilh Seaion ]000) W Di.�pion J M Ihe
Buain.v ena r.des.kve codeJ «�na ne «.n. u u,mp in>eM1wn .nd me b�. I« nb .n.cw e.empun. My vidmia, d seaon
]W 1.5 Ey vry eppli eN la a permE aiEjeG� iM eppficeN to e dW penetly W nol mae �hm iNa huntlrad dWva �5500�.
� I.mowrcrtltAeP�De�YamyenWM^mw1�w¢Qyuthaisolemm0�.wdldotheMark.endtlwewr�urounol'uNeMed
oe ollered tar eeb (SactionlWa. Bueimn aM PMeasiom Cotls: The Camreem lioeme Lew doaa na ePdYto en ownxd poperty
wlq buiOs a in0� IM1aeson. md wfio Ams �urh wvk h"vnaetl a MnN rc tlrury� hu a Iw orm amG�W�. qo+� lM wM
Lnpwa�enb ve ria ineMed a dlsed la Ws. tl. bvewr. Ne bwldi^0 a inpv.a�W b roN wuhm ww Yaer W comG�un. Ne
owmrbuilder win liare tM dnden d pwiiq M a da dd b GdC a"unpws la iM pvpas d eele).
� 1. m owmr d the qW�Y. em uduiN/ mMrenM wv� 6cene� mroecbn ro muuue IM pNa (5aaion ]oH. Bwmw� vd
PMauiam Code: The Cavratlm licrw ter doa+ m Voh b an vxnx d PW„Y Mc do'tls a nwa'm Ilsaan end Mn
convena Ia wN wqetla xvh s mm�adule) �enee waem m tM Cmtrm� Licanss lew1.
� I em uanq undm Satlon: B. 8 P.C.. br No �mwn:
om.: w,w:
I do Mrob/ cMM thet I em awera d eM uMasuM tty rp�unmema W Gliomia lbsEh eM Selery Code Sadion� 25505.2553J. vM
TSSL. enE UW I a enV Mws buiNcq om�p�W WI / w11 nal (drt�b orc) naeE to oonW/ w,h uid aata coEe� end �M �pu4emend la
IWOFKER'9COYYEMS�TONDKWIATtON:IMrr4yyfirm�uWrpp�epydpvWyonsdlMlaYw'updetlerelum:
� IMnaMMilmeeuenemtl"cWdmmeNloNtliiw�bwaken'miq�atbn.npwNNlvEy9anion9l0pdtMleEar
cod.. �« �n. wnmrorc. a m..M �> wlicn mi. wm+: u.�ea.
.fl �nm.wwi�me�menwn..•m�w�onma�i.no...sremmsdMsw�marooam.�.ec.eoee.wmeo��w.am.
1� ran la .n:n m'v wm+ u muea. Mr.aren' Wmpruq;on :muanc. an:r ad w�v �onn« en:
c.�;..: STATE FUND EXPIRES
Pdiry Number. 0 1/ 0 1/ 9 9
�m;s .xiron r�sse �a e. camderoe i m. w�e u rs a,s nu�nna adws Isrool n w.�
� I ceMly Ihet in the peRo�manca d �he work la r,�Kh I�b pem�n u'veusd, I Mell ml ampb/ eny pamn in eny mannu w u lo
e wEjetl to IM wAw�' mnqeiuetion 4we tl Cefdotlmgu�. be�Mwa!�pres tlW ! I Mauld beconie eubjetl Io iM xaMeit'
D: m mnmtion � Da saco� �� tM �iwa: Il � C/ / AI/L<�L(� s
. a: F.uun ro.cun ro�t.r: mnw��aen,�mv..y. �. unl�.M..�a.IWr.ueK�.n wnv�m� ro almre� mm.rou nre
nnu'q ro arr n�ndrM fhowW ANhn ftlCqOppA h Wmdon ro fM cwl al eompru�Wit demps u povWM br In
9�ctlm ]106 0l tM I.�Eor COW. IN�n�L ����»Y'� ��
COHSTIi11Cf10N LENpNO RGENCT: 1 lw�ab/ elfum ivdr psieCy d pxjsy OW Ura e e mWiutlian kMi�p ysicy M Ns
pMamenm d tM work tor xhi�li ihu W^^i u ewd (Seebn �06). Cw. C).
LENDEfl'S NAA1E:
LENDER'S RDONE54:
I eeNily thet I heve emd this epp�ion erd pme tlw Ry abova iNpmmion ia eana. I eyme lo eomply wilh eY dry ard mu�7 oMinenme
eM etma lews nlmiq to buJdip wnatrumon eM herapy euiMrce iepresentetms d �M ery lo aMa upon tM eEave.meMioneE qoporry
�« ��'°°""° "'�'°' R I CHARD CAItD
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�/ / � Daro:,L"'.��
'�� a o.�,� ic.m
(5151�i8.WP) WMsBiddii085e1sY���ee�-Fda:CenmY-MPN'�:Pink-iWwM:OaNauod-A+aesv
COMMENTS: X
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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 RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PAOV: PAACEL: 13906624 ZNE: REF NO: .
PLANNING NOTES>•,
i "_
iE if 7k iF i6 iF ik if iF 9E 1E 1E iE iF iE ik if iE if iklE 1f it ik 3E iF 1E 1E iE jE 1E 3E iE �E iE if if !f if ik if iF ik fF af iE iE jf iE iE if if if ik i! iF if iFlE iE it iE iklf ib aElF if iF k 1E iE if 1F iE iE �1E iE if
D E V E•I; 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: �
I+
HUILDING APPROVED BY : DATE: '
.� q
APPLICATION ISS�UED BY: DATE: �� � o
iEiEiEillkikif7F�fiElEiFafiEfEiEiEiflFif�flF iEiPiEiFiEiEiEiFifjE � ifif
LEGALIZATION:N F E E S U M M A R Y STRUCTUR L SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 62.25 50
SMIP/NON—RES
PLAN
ZSSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECI( TOTAL PAIU DUE
TOTALS----> 62.75 0.00 0,00 62.75 62.75 .00
REVENUE DIVISION TOTALS--> COLLECTED; 62.75 OVER/SHORT: .00
HLDG PMT PLDMHZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECiC
62.25 .50
ik iE iE 1E iF iF M if 1f 1E iElf if iE 1E if iE �f 1F 1t iE IE iF iE i! iF iE iE iE ik iE jk 1f fElk ik ik IE fF �E �F iE �F ik 1E �E iE jf ik 7k aE 1E iF if �E 1E 3E �f fF af jE 3k 9F fE iE iE iE if iE k iE iE 1k jF iF iE iE �E iE
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFA 1976 REROOF BY VALUE RESIDENTIAL NOZONE 1.00
END OF FEES
� � ��� �-`�-S��q�
� ''
1,976,00
B1-2B-1998/BB:17 AIVf62.75
RCPTN:01-8818369
PERMIT:e86634
.. CONSTRUCTION AND PLANNING POOL & SPA
qPPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
� t. TemPorary Electrital Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. Elettrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. - 55. Electrical Bonding �
5. Steel Refnforcement • 56. Rough Plumbing & Pressure Test
'6. Elettrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-lJndrgrnd.
8, Foundation 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, O Undrgrnd.
10. Structural Floor Svstem 61. APPPOVAL TO DECK
� 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63, Heater & VenbFinal '�
13. Roof Dreins . 64. Plumbing System • Final
14. Rou9h Plumbing � 65. Electrical-Fina� '
15. Rough Electriwl•Conduit �� 66. Solar System-Final
16. Rough Electric Wiring � 67. Fencing & Access ApProval �
17. Rou9h Wiring Sign 68. APPROVED FOR PLASTERING
18. flough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ven'tilating 77. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing , 73. Undergrnd.StorageTank OGas OOiI
25. RoofSheathing `r�,�' �a�t/6'C 7q, pverhead Hydro
26. T•Bar Ceiling IStructural) & Monocoat 75. Dry Chemical � �
27. Prame and Flashing 76. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coac 79. FINAL INSPECTION
32. Electrical Power Meterfinal 80. f00P CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning � �
35. Final Gas Pipe-Test , .
36. Hood or Canopy
37. Fina� Factory Fireplace .
38. Fina� Plumbing
39. WatBr Service-Final �
40. Gas Service-Final
41. Solar pomestic-Finai
42. Backflow Preventer
43. BackNow Irrigation
44. Landscape Irrigation System
' 45. Sound Attenuation . ,
46. Handiwp Regulations � . .
47. FINAL STRUCTURE & BUILDING ��3-,�% G�-
. 48. FINAL PLANNING •
_ 49. Etectrlc Release to Edison - �� -
50. Gas Release to Southem Califomia Gas Co
51. CERTIFICATE OF OCCUPANCY - +
No Date
vn�n i�_ -',ra�:t
•,cT zo-,�«,S�oo 9.�R� uo.00
CITY OF COSTA MESA PLANNING DEPARTMENT
A.P. No. �S e€�-�
Bldg. Permit No. n�d���v
i _
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address 3261 Daknta !?ve_
Owner's Name P1. J. Ontko
Bachelor or 1- Bedroom Units
$25.00 =
2 - Bedroom Units 1 @ $40.00 = ;�40.00
3 - Bedroom Units
$55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00 = -040.00
Total Number of Dwelling Units 1 Total Fee
Planning Department Approval Date Park Area No. �
By WLDbb Applicant's Signature ''��%+��Gy�iC �(��
CITY OF COSTA MESA PLANNING DEPARTMENT
A.P. No.�o�_�
OCT 20-7?uisa�0 942Ro�***40.00
Bldg. Permit No.
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Payment Receipt
Project Address 3261 Dakota Ave_
Owner's Name
Bachelor or 1- Bedroom Units @$25.00 =
2 - Bedroom Units 1 @ $40.00 = �40.00
3 - Bedroom Units @ $55.00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00 = �40.00
Total Number of Dwelling Units j Total Fee
Planning Department Approval Date Park Area No. �
By WLDbb Applicant's Signature ���� ��✓�Hf�'
GENERAL CONTRACTOR CC
AP No.l�Q-(�G-ll LOT
INSPECTIONS
coat
DAT�
:Sl COT1511. VALUE $ Sj4� W
TRACT FIRE ZONE DlSCRIPTION OF WORK
Signature DATE GROUPJ TYPL IZI ZON�
FER\4]
SUBCONTRACI'OR �1—
� 17766
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. 90X 917 COBTA MHBA. CALIFORNIA
For Applieanf fio Fill In Compiefely
YYPE OR PRINT
■ ARCHITECT
■ STATE
COSTA MESA
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TEL.
■ BHTOACK LINB FROM
TEL.
NO.
TEL.
NO. OF 6LD�8.
DESCRIPTION OF WORK
BUIIDING ,�� NO. OF
SIZE ROOMS
EXTERIOR WALL ROOF
COVERING �- COVEF
USE OF BUILDING AND WORK 70 E
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I HER6BY ACKNOWL6OGH THAT 1 XAV
ANO BTATE THAT �BOVE �5 CORI
PlY WITH All. Cl dR� ��5 MlD
BUILDINO CONB
SIGNATURE OF
PERMIt7E
AUTHORIZED AGENT
FE`E RECEIVED
sEP ��sa 0 �"�
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HECEIPT NO. P)HHM
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BUILDING �n /_ / /y�� %��
ADDRESS lXCrJ ✓�lttJ�v
COSTA MESA, GALIFORNIA
FIRE
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A. P. NO.
YARDS EVES
LINH BTJ
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THIe APPUGTION }ry¢ ANOUM BXOWN UNOER VALUATION IB FOR THE
J AGRE TO COM- pURP088 OF EBTABLIBHING A PERMIT FEE ONLY.
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�.i VALUATION ��j �� A
` PERMIi FEE $ L;/! W
g 33`�� V� P�N CHEGK b
iOTAL FEE � " `�
OWNER
�JOB ADDRESS
GENERAL C0�
� AP No. � �o_i
� INSPECTIONS
\ SOIL
GAS
WATER
ROUGH PLUMBING
PROP. $WR. LINE
SPRINKLING SVST
MISCELLANEOUS
FOUGH HEATING ANO AIR CON�ITIONING
TEMPORARY SERVICE OR POLE
UN�ERGROUN� � POWER �
ROUGH WIftING,
TRENCHES FORMS . STEEL REINF.
FLOOR SVS EM
BOND BEAM � STEEL REINFORCE �J
SHEATHING
FRAME ANO FLASHING
LATHING - IN OUT
PLASTER,BftOW COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. ANO A.C., FINAL
PLUMBING, FINAL AND GAS TEST (�
ELECTRIC, FINAL
BUILOING. FINNL
TRACT FIRE ZONE
DATE 10/20/72
BUILDING PERMIT N0.
< Remodel & add
VALUE $ $,250.(
SUBCONTRACTOR
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P�1000 943� *'�:�62.G8
�CT 20-7�
35596
COSTA MESA BUILDING•SAFETV DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
AP LICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely R i V ATE RECEI ED
^ DATEISSUED
BUILDING J'�6I DA.FOTA '7�F •G"�_ �"�"�•
ADDRE55
,/� PEFMIT NO.
OWNER �A%IHFL✓ �• o.t�nTrp � A.P. No.13w� V �..
BUILDING /
ADORESS SqMF Ar AGoV� ADDRESS '�y( �
CITV CD S T� MFf� •�A No��SY6-/7/S TRACT i/�� LOT BLOCK
CONSfRUCT10N NONE
LENDER �
BHANCH ' �-�+
OW EF /
ADDRESS -/ e O
r� � YALUE ,
ARCNITECT ��N�.� TEL. S eC / N $
OR ENGINEER N
FIRE
ADDFE55 ZONE � TVP� GROUP
CONTRACTOR OWNE� ByPROV D/� DATE �'—' �+" '
ADDRESS
TEL. ZONE �/ NO.OF USE OF NEW N/�
CITY NO. p�-Z P�� � BUILDING � �0
STATE CITY �'ARDS APPROVED VARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SIZE � X fOD � NO.OF BLDGS. (FROM C/ E
OF LOT 6 S NOW ON LOT � RONT FT.
usE oF f�pMF /r6SIbrCNct � `F
E%ISTING BLDG. ���j.�-- F . FT
NEWBLDG. SSO SG� %T ROOMS �^ STORIES / 1.51DE �T. FT.
COVEERINGALL S�GGJ COVOERING 'f���� ���� REAF lirFT. FT.
VSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN &
MAIN BLOGS. ACCESS. BLDGS.
HOMC A°ESIDFI✓LF: ADO 2 iPUDMS VAR.# � DATE
C.U.P.�{'+ APPROVED
���.%C1?h%/0 JS'� EMG �7 �R�VED /� �b�2D�Z�
I hereby acknowlatlge that 1 have reatl this ap0�i�ation antl stata
tha[ the above information is cOrract antl apree So comply with
all laws reBulatinp bui�ding consvuction, enC I shall not amploy
any perwn in violation of Me workman's compensation faws ot
Me Staie of Califomla. �/- T� m
I heraby car[ify ffiat I am propetly licensetl as a contractor untler `- SQ. FT. o
t�e Stata of Cali4ornie Busineu antl Profeszions Cotle, Dlvlsicn 3, TNE AMOVNT SHOWN UNDEF VALUATION IS FOR �
C�ep[er 9, antl that such licenses ere in full torce entl effect, or I THE PURP06E OF ESTABL6HING A PERMR FEE ONLV: m
um exempt trom Ma provisions of Me Stace of Calltornia Buciness VALVATION
and Protassions Cotle, Divizion 3, Chapter 9. f L� ry
� P MR FEE 5 ]
Sipnature ot 6y� D � /� m
P¢rmittee ��i/J � $ � �( ;�� PIAN CHECK $ iL/. � Q
�/ T �
Aut�otizetl Aqent �{ LL
TOTAL FEE $
Lot 57
Tr 3722
�����
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BO% 917 C08TA MESA. CALIFORNIA
For Applteant to Fill In Completely
TYPE OR PRINT
CASTA MESA CALIFORNIA
■ ARGHITECT
FEE RECEI�lE�
(� �'��—.�00 � �1
FlNANCE DEPT.
,�PPLfCiATj101`l FfOR;RERMIT
BUILDING
For Office Use Only
nece�rr Ho. a e�YA�Tlh�
BUILDING
ADDRES6
FIRE
ZONE
APPROVE[
BY
ZONE
pY
OATE IBSUEO
COSTA MESA. CALIFORNIA
ZONIN6
NO. OF I U6E OF
PLANe n BUIIDI�
� � No. 61195 No r;i6-3zz9 �E�•�
DEBCHIPTION
SIZE I no. ov e�ace.
OF LOT NOw ON LOT p, p, NO.
USE OF YARDS EVES
EXIBTING BLDC. APPROVED ALLO
68T0�CK LINB PROM <ceNTlR LINe BTJ �>
CeNTex on sTweeT S� REAR YARD � FRONT L�/ FT.
SIDE YARD LEFT `� r I RIGH7 lo � R. SIDE O FT.
DESCRIPTION OF WORK
SZEDING l�g5sf ROOMS
EXTERIOR WALI ROOF
COVHRING GOVEF
USE OF BUILDING AND WORK TO E
"'Sine e r rni v
Shingles
and Attached Garage
Plan 3-C �
I HEREBY ACKNOWLltl�e TXAT � HAVE RBAD TH19 APPLlGT10N n�e AMOUM BHOWN UNDER VALUATION IS FOR THE
ANO�BTAT¢ tN�T TH6 ABOVE IB COPRECT AND AGRCe TO COM- pypppeE OF ¢9TABL18N�NG A v6qMIT Fee ONLY.
PLY WITX ALL CITY O��NANCEe A 6TATE CAWB 11HOULATIN6
Bu1lDINo CONBTRUGi'ION� VALUATION ^j/
81GNATURE OFf � -) — Q_ PERMiT FEE S4} K/ �
PERMITTC � 7 Qfj /yA
S %�/�✓l� / pLAN CHECK $ O �
� AUTHORI2ED AGENi � � _ _ _ _ _ i{"1J�
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