HomeMy WebLinkAbout944 DARRELL ST - Building Permits�.
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• . � � CITY OF COSTA MESA ' - �
�`""'F= B!/ILDING DIYISION
F` � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: E09-00035
PERMIT TYPE ELEC STATUS: ISSUED
APN: 42235229 DATE ISSUED: 0 211 112 0 0 9
�"'i^�';��e-ISSUED BY: BJK
JOB ADDRESS: 944
Vicinity: REAR SFD
SCOPE OF WORK:
CHANGE-OUT OF THE
OWNER: MARES,
PHONE:
APPLICANT: LEYVA,
PHONE: 714323
CONTRACTOR: RO
Address: 953
City/State: C07
Electrical Plan Check
Electrical Permit Fee:
Reinspection Fee
TOTALFEES
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenls under Califomia 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 compty with all applicable wdes, 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.
COOEt. INSPEG710NTVPE DRTE IN1111RL5 LODEO INSGECiIONTYGE ' �AIE INIITALS
7616 Fixed System Pinal Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roo( 210 Final Electrical ��
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201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Fin21 Si�2
204 Final Demolition 250 Final Building/Octupancy
� E:
WORKERS' COMPENSATION DECLARATION: . .
I hereby affrtn untler penalry of perjury one of the (ollowing:declara�ions: ..
❑ I have antl will maintain a certifcate of consenl lo self-Insure (or vrorkers'
compensation, as provided (or by section 3700 of the Labor Cotle, for,the
pertormance of lhe wOrk for which this permit is issued.
❑ I have and will maintain v.orkers' compensation insurance, as required by
section 3700 of ihe Labor Cotle, for the peAormance ot the work for which this
pertnit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(IDis section neetl not be wmpleteOAfhe pe�mR is valued at we hunEred �tlars (5100J a less J
� Policy Number:
��j I ceAify that in the peAortnance ot the work for which this permit is
issued, I shall no[ employ any person in any manner so as to become subject
� to the vrorkers' compensation laws of Califomia, and agree that if I should
�become subject to Ihe workers' compensation provisions of Section 3700 of
the Labor C , II f with co ply with Ihese pmvisions.
2 -/��D �(
� �piiwnYsSignaWre� oa�e
�l
WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND�
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby af6rm [hat I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of lhe Business and Professions Code, and
my license is in full force and eftect. �Z
'Lic.—.#` �2 5��� L% Class#� �/
_�. �r-��-yn 2 i � `�
va ars5ignaWre� Dale �
t�^ _
CONSTRUCTION LENDING AGENCY:
❑ I hereby affrm that there is a conswction lentling agency for the
pedortnance o( Ihe work (or wfiich �his permit is issued. (Sea 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 703L5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior lo its
issuance, also requires the applicant for such permit to file a signed statemen[
lhat he or she is licensed pursuant to the pmvisions of the Contractors
License law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business antl Professions Cotle) or that he or she is exempt lhere(rom and
the basis for the alleged exemp�ion. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalry of not more than
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO 7HE WORK, and the structure is not intended or
oKered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply lo an ovmer of property vfio builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided lhat such impmvemenfs are not intended or oReretl for
sale. If, however, the building or improvement is sold wiihin one year of
complelion, 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 WI7H
LICENSED CONTRACTORS to conswct the project (Sea 7044, Business and
Proressions code: The contractors License Law dces not appty to an ovmer o!
property who builds or improves thereon, and who contracts for such project with
a cont2ctor(s) license pursuant to the Contractws License Laws.).
0: I�am exempt under sec.
Business and Professions Code for this reason:
Signature �ale
305]-45(3/0])
�; Owner ID verified hy drie, ..cense. ❑ Yes ❑ No
� Driver's License Na Expires:
Verifcation o( Ownership by pype of tlocument, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby ceAAy that no excavation frve (5) or more feet in depth into which a
person is required to descend, vnll be made in conneclion vrith work aulFwnzed
by this pertnit, and that no building s[ructure, scaffdding, (alsewurk, or tlemolition
or dismantling ihereof, will be more lhan thirty-six (36) teet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Ttle 8, Califomia Administ2tive Code).
❑ As owner-builder, I will no[ employ anyone [o do work which would
require a permit from the Division o( Intlustrial Sa(ety, as noted above, unless
such person has a permit to do such work from the division.
Applicanfs SignaWre Dale
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future 6uilding occupant need ro file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed wi[h the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazartlous materials equal to or greater than a weight of
500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressed gas
at s[andard IemperaWre and pressure).
2. Does or will the applicant or present or (uture building occupant need to file
a regislration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safe[y Code, with some
exceptions, requires regishation wilh the Costa Mesa Fire DepaAment by
each business which at any one time has on hand a quantiry of acutely
hazartlous materials equal to or greater t�an a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperaNre and pressure).
3. Does or will the applicant or present or future builtling occupant need to
prepare an RMPP (Risk Managemen� and Prevenlion Pmgram (or acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Calitomia Heal[h and Safety Code provides that the
Costa Mesa Fire Department may require ihe preparation, certifcation and
fling wiM the Fire Department of an RMPP 6y businesses which are requiretl
to register acutely hazardous materials with the Fire Departmenc "
4. I( an RMPP is presently required, has Section 25534 of the California
Health and Safely Code been fully complietl with? ❑ Ves ❑ No
5. Does or will Ihe applicant or present or fuWre builtling occupant require for
the vrork which is the subject of this application a permit for such construction
or motlifcation (rom Ihe SOWh Coast Air Qualily Management District or from
any other air polNtion control distnct or agency? ❑ Ves ❑ No
(Secfron 658502 of the Califomia Govemment Code requires that the requested
infortnation be fumished on applications fa non-residential builtling pertnits).
6. Will any part o( Ihe facility to be constructed untler this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
Qf "yes", the facility must meet Ihe requirement of Sections 25534 and 42303
of the Califomia Heallh and Safery Code).
Z If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for [he work which is [he
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'j�es", attach certificate of compliance from the appropriate air pollution
contml oKCer�.
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is covecL I agree to compty with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read Ihis applica�ion and 5ta[e tha[
the information given is correcL I agree to comply with all state laws and ciry
ordinances relating lo building constmction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authorized by this permit until final inspection.
SiqnaWr �I 1s) �ate �y
✓�/ /G.v// � —��'�/
AntllorAuthanzetl'AOPlicant-�.A �Oate�
Sih�ia Kcuncrson FAX # (714) ;'r_ �330
C1TY OF COSTA MESA
1�'eighborl�ood Improvement Program
Tinal Work Write Up O1/29/09
N�mc: Juan Maccs
Prouertv Address: J44 Dm�rell Strect
liomc Phonc: )d9-642-7910
Work Yhonc: N/A
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All work is to be done per City of Costa h4csa Building, Plamiing and Public \i�orks Codes. In order to establish standards
of quality, thc detailed specifications may refer to a ccr[ain product by name and/or from a major manufactivcr. This
procedurc is not to bc con'strucd as eliminating from compctition othcr products of cqual or bcttcr qu.dity by othcr
manufacturcrs. Thc Contractor shall furnish the lis[ of proposcd dcsircd substitutions prior to signing thc contract. All itcros
listed on ihe work description, unless otherwise specified, shall include all potching and finish work, including trim,
harchcaYc, patchin� mid finish painting and/or staining. Thc Contractor is responsiblc for all permits, fccs, City busincss
liccnse5, plans, c[c.
City of Cos[a blesa Standa�'d Rehabilitaliun Speci�ications applies to all items Iis�ed un ��'ork descripti�n.
1. Electrical Serrice Panel: Upgrade elcctrical service pancl [0 200 amps to incet
cw�rcn[ cicctrical codc requiremenis. Obtain required penni[ f�rmu tlie Building
2. "Permite Damape: Pvaluate possible termite daniage in attached garage. Providc
cstimate for full tcrmiro trcatment including sublerrancan.
3. Drh e�� a��: Provide m;iteri:d aud labor to remove and dispose of existing drivcway
and replacc �ti-ith concrcte drivcway. Provide stcel reinforccmcnt per industry
standacds, edging forms, expansion joints and drainage pilch to City code. Pour,
vibratc and broom finish 2,500-psi concrctc to codc dcpth. Approsinmtcly 3Sx 12'
(d20 s.f.l.
TOTAL
i
c: �
52,300
S 1,300
Sd,200
57,800
1 havc revie���ed Ihe above-�vork description and understand tha[ any changes, additions or dcietio��s shall ha��e prior
approv.il by thc City of Costa n4csa A'cighba hood Improvemcnt Pcrsonncl.
Sfgnaturc of Property Owncr
Da1c
Signaturc of ConVactor Datc
. , l:
Applicant to f111 in all spatts exceD� those within heavY bortler lines anG.sign all aporopriate tleolarations. � ' '
� Tv oF coS�fA M/E/$'q/, (��Q NS�T�R/�JfJJ�` TION PERMIT PERMIT.NO. TRACT NO. LOT NO. UN1J„�V6. � ' � T� ,� ,
;�Pro�ect Address i�T 7 /JeL'2<�2GF�C_ C � ti�1/. `�, (� . 3O � . . -� . � �'�.:. � � L._..t_° E ��a �` ' � � . '
ApplicanYs Mailing,�idress �LL7G SQ�d�<«SGO JT • �, y, TYPE OF CONSTRUCTION NEW ADD ALTERATION - REPAIR -� �
Owner'S Name ��� ��OCSFhLC � CONVERSION � DEMOLISH ❑ OTHER - � ' "' � -I -
Phone S$/'39Z3 A.P. � ' I G p�;' . � Zone
/� DESCRIPTION F.W RK/USEOFBIDG. ��- C e� G� ,
Address� C�7�.L' �7�{QpEU GPoJG h��� ���u� S�� �j�p-� S MainBuildiny: (' i AccessoFy,�uilding: _
E , .. Z
A�Ch/Eng. LiC¢ns2 NO. TVPE F PERMIT ADING FOU DATION STRUCTURAL � T FIOOt � _���- O
Add�¢55 ' ' ❑ TENANT ❑ ELECTRIGAL ❑ PLUMBING ❑ MECHANICAL B R¢d� � � ^ J�ry (F�=,J• . N
COnlractor'SName 'Phone �'�THER ' A �
� PROJECT DESCRIPTION 5(7. FT. OCCUPANCV C Right N
Addfe55lmailing) - ' r' CONSTRUCTION TVPE 'VALUATION $ �04� � g Left ' ' . � . p
City Licensc No. _ ZpryE GRADING CU. VDS. ACRES '
LICENSED CONTRACTOR DECLHRATION � Plilg. R¢f. �i-` ' Pa�king RBq./P�Ovided � � E-
I hereby,affirm that'1 am�llcensetl untle� provisions oi Charte 9 cominencin � � . n
( 9 Remarks: . Planning Notes: . . M,
with section. ]000) of Division 3 of the Business antl Gwt ss On de, and �
5ny licenz �i in full fArte antl e f¢cL � . � � " . � . T
i nse las ' e seifJ � S
at i naWre w� � G
PLUMBING - FEES
��- ER ' COMPENSATION D LARA Ba� $ink ShOw¢rs ! �'
1 hereby affirm that I have a ceriiticate ot consent to sel(-insure or a certificate � ELECTRICAL . FEES
.of Workers: Compensation Insurance,� or a certifietl cooY thereoi (Section . � gackflow Preventer '- Service Sink � ' - -
3800,.Lab. C.) i A
Automatic Washer Transformer 0 15-50 KW "-.
Policy No. Company BackfloW Iffigation ' Sewer Ca � ❑ 50+�KW -
P Canstruction Pole Sub.
❑ Certitietl copy i5 hereby fumishetl. • � .
❑ Certifietl <opy is filetl with the city Buildin9 Division. Bathtubs i Sewer Connection Cookin9 Unit , . Meter ❑�up to 100,amps
Da[e ' AppliGant � "'
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Cla�ifi2�s - Sola� COIIecLOfS Di5hwd5hE� ' .MCt¢� ❑ov¢� 100 dmps
(Thissection neetl not be-completetl if the permit is tor� one huntl�etl ($300) or - � - - � ' "
Iess): ' Dishwasher " • Solar Pipin9 , • . Dryers ❑Gas � �Electric �Suh Panel • 7
1 certify [ha[ in the perto�mance o( the wo�k for'which this pe�m�t i5 i55uetl, I� . - - � ' '� �
sha11 not employ any person in any manner so as to become subjeci to-the Drinking Fountains Solar Tank � Fan � Motors DO-1 HP �1.'h'- 8 1
Workers/�ompens�tl�o s of Califomia.(� ,y,� !� • ' � • �
Date �• �ignature �1 • (� • � ���9_��� h ��L Floor Drains! � � Swimming Pool w/Spa � � F.A.U. ' .� .Inc.Solar.09-15 HP 016-15+ �
'NOTICE: If, after making [his tleclaration, you should become subject to fhe ' �
.Workers' COmpenSation provisions of the.Labo� Cotle,-you must forthwith. - FIOOfSinkS �- - � U/indl � - -�- -- � � -� � �--- - '
comply 'with sucn ,provisions o� thi5 permit shall be tleemed �evoketl. ' Fixtu�25 ' ' Microwdv2' �"
CONSTRUCTION'LENDING AGENCV' ' ' . ' ' -' - GdSS¢rvic¢ 'Outi¢LS .WatefC105¢t ' Y DeVICe;80%¢5 � �
I hereEy affirm that there is a mnstructlon�lentlinq agency tor tM1e pertormance ' '� - ;� ' - Pole Light ' �
of the work for which- this pe�mit .is -issued -(Section 309]- Civ. CJ Interce t0�5 - ' W2t¢� Heat¢� � r . ' �
Lenaer�s Name, � - P � Outlets'�, Range - �
�entlerrnaaress �� 1 � � ' Kitchen Sink � � Watei Service � ' � � Switches° � � � ? � � �
OWNER BUIIDER DECLFRATION ' � ' ' • � � _ ' ' Sigp %
I hereby af�irm �that I am ezempt from the Contractor's License Law tor the Lavatories ' �" � Auto-Wash . •- (." Gar6age Dispoul � ' ; Standing�Sections . �
tollowin9 reason' ($ection 7031.5 Business and Prote55ional Cotl¢: Any city or , �- , ' � � .
county whicn requires a permii to construct, alter, improve, Eemolish or repalr p-Tiap; . ' � Laundry Trays _ 1 Generetor �0-5 KW �5-15 KW � `� '
any st�ucture, prior to it5'issuance, also �equires the applicant for such permit T�dSh COTp2cto� .
to �ile a siqnetl statemen[ tM1at he/she is licensetl pur5uant to the p�ovisions ot -�ROOf D�2ins � � • � - � �
the Contracior's License Law (Chapter 9(commencinq witn Section ]000) ot - . K
Division 3 ot the Business antl Professions Cotle) o� that he/she i5'exempt � � �� � '�' . _ ' ,
tM1e�efrom antl the basis for'[hE allegetl exemption. Any violation of �Section �� . . , - " `' . ' ' � '
7031.5 by any appliGant for a permit subjects.the applicant to a civil ,� •�� �'''�-+�
:eenalty ohnoj more than five M1untlretl tlollars ($500).. - , ' ' ' �. " ' • .
LJ I,• as owner of the 0/operty or my empl0yees' with wage5 as thei� sole �R¢inSpeMiOn F@e � $15 '� � Issue Fee $�3 F' �
mmpensation, will do the work, antl thesVucture is�not infentletl or oiferetl ' ' � � ' ` , . �$ 3
for sale (Section ��044, Business and Professional Cotle: The Contractor's'; � � MECHANICAC � ' FEES ' Reinspection Fee � $75 Issue Fee. i
License Law tloes not apply to an owne� ot a property who builtls or improves . . -- .
thereon, antl'who does such work himself/herseli or mrou9n his or,her own ,. � - . DEVELOPMENT SERVICES REQUIREMENTS:. r
employees, provitletl tM1at sucb improvemen[s are not�infendetl or offeretl�for BOilef �; . HOod OI� Typ¢ I ❑ • - .' � ,� ' � i , � +
sale. It, however, lhe bulltling or improvement I5 soltl within one yea� of com- . � Cynopy � TypC I Ir ❑ . ' 2onin8 APProved By Date ' �
pletion, tne owner will�have.the burtlen of proving he/she tlitl not builtl or�im- Duc['- Under Ground . Bu�lding Approved By. Date �(
prove for lhe purpose of sale). . � � . + ' ' _ � /,
❑ I, as�owner of Ihe property, am exclusively contracting witti licensetl con- . Duct-Structural . Refrigeration System . t AppliCdtiomlAU¢d By - � Dat ' V �
t�actors to canst�uct the project (Section ]066, Busine55 and Pwfessions Cotle: � , . .
The conlractor's License Law tloes not apply Yo an owner of property who . Duct - Ventilating . � _ , ❑0-700,000 BTU ❑100,000 BTU i ^', . SUMMARV OF FEES � . � � •
�builtls or improves [hereon,:antl who contracts for such projects"with a con-�' ' ' � � '^
tractor(s)�license pursuznt to tne Contractor's License Law). 1 am aware Nat � - � . �BUILDING PERMIT �$ '�' 7•SO� SMIP �$ �' Sv
proof of thei� Wo�ker's Compensation insurance should be provitletl to me. : ExhdUSt System ❑ Multipl¢�❑ Syst¢m Repdif/Alt¢�dti0❑ - . . _ �
PLANCHECK $ <<' 3� PERMIT . ��
❑�I am exempt under Section B: & P. C. for this reason ' Pirepi/Fact. BIL ICBO # � Fire Dampers � PLUMBING + '� $- � 'ISSUANCE � $-
Da�e Owner ' � � • Heating System & Ducting Registero � / � '� � ENERGV P.C. � $ � +
� PLAN CHECK 25%� S � �
�I-hereby certity that I have reatl�this application antl �stat that the above ❑0-100,000 BTU'�100,OOOBT � • 1 -- �� - GRADING �$ !
information is correcc. i agree to comoly with all city antl county ortlinances � t ELECTRICAL ' :$ . �'
antl'state laws relatin9 �o euiminq construction, antl hereby authorize repre- , . ' � PLAN CHECK 50% $ MICROFILM i$ ' �
sentatives of�[histcity�to enter upon me above-mentionetl property (or 1 . � � ' �
inspection pu pases. '— ` �,e ' � � ' ' MECHANICAL , � § - , TOTAL FEE $ Z� •3�
Signature � `�"�o Oa[e�(�S i ' �
Drivers' License or 55 � - - V ' Reinspection Fee '$15 , � luue Fea $ 3 PLAN CHECK 25%' $� � � F.
1F OB65-46, rev. 10/84 White - Builtling; Canary - Applicanp Pink - Accounting; Goltlenrotl - Assessor ' � �.
. . .. . . , _ . , .... . _ u.' x�
t
��� CONSTRUCTION AND PLANN'iNG' � ' � POOL & SPA . _ ,
r� ' '- � - Date Inspector � Date � Inspector�
�
`APPROVALS � Permit # APPROVALS Permit #
1. Temporary Electrical Service or.'Pble - 'a 52. Pool &'Equipment Location ' � 'a
.
�2; Soil Pipe-Undrgrnd. � � . :�.�! � � , 53. Steel,Reinforcement � , � � '
3�t��ictrical Conduit Utility-Undrgrnd. 54. Forms � - r� .
I� � � � . . � . ,
•4. Electrical�Conduit-Undrgrnd. . �J 55. Electrical Bonding � � ,
5. Steel Reinforcement ,' �� � 56. Rough Plumbing & Pressure Test , �� '
v
��6. Electrical UFER Grnd. ,� - 57. APPROVAL TO COVER-GUNITE •�, �,
� 7..Footings. ,� , � . , `' 58. Electrical Conduit-Undrgrnd. ��. �
' 8. Foundation � ; '- . ;�� _, - � 59. Gas Pipe, O Undrgrnd., Test • � � _ '
:9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P-Trap, � Undrgrnd. '
10. Structural Floor System� .� .� � 61. APPROVAL TO DECK �
11..Property Sewer�Line & House�Connection , 62. Backwash & Receptor-Final �
12. Sewer Cap � 63. Heater & Vent-Final � -�
t
'� 13. Roof,Drains ' ��.� � 64. Plumbing System - Final " ` � �
� -
� 14. Rough Plumbing - � 65. Electrical-Final . ", ' �
, 15: Rough Electrical-Conduit . � . 66. Solar System-Final , ' '
'�16: Rough.Elecfric Wiring . ' � 67. Fencing & Access Approval ' '
17�. �Rough Wi�ing.Sign � - ' � . � 68. APPRO.VED FOR PLASTERING -
' 18. Rough Electrical;T.Bar Ceiling � 69. POOUSPA SYSTEMS FINAL ' .
19. Rougli�Heating & Air Conditioning FIRE DEPT.�REQUIREMENT .
, 20. Rough Factory Fireplsce � � APPROVALS Permit# �
'� 21. Ducts, in SVucture . 70. Underground Hydro ,
'� 22. �Ducts, Ventilating , 71.� Product Piping � Gas ❑ Oil '
�� 23. Gas Pipe-Rough & Test . � � 72. Underground Flush �
� 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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. FIREPREV.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 '�-�3-g� �eft
35. Final Gas Pipe-Test � � � - � � . /�/U 6N' / a,c.t - d-�t
36. Hood or Canopy ' , ' _ � - � �- `-
37. Final Factory Fireplace � � � , � . �
38. Final Plumbing . ' ' �. ' �
39. Water Service-Final
40. Gas Service-Final � , � '
41. Solar�DomesticFinal ,_ _, .. , .
42. Backflow Preventer� . _ ' � � •
43. Backflow Irrigation, { , � - �
44. ,Landscape Irrigation System _ . • � . � � �
45. Sound Attenuation � � ' � � � - -
46. .Handicap Regulations � .� �� � " � � � � � . . .` �
47..FINAL STRUCTURE & BUILDING � ' '
. ' y. � � �. .
48. Special Requirements Completed � . , Jr
49. Electric Release to Edison � ' � - � • �' ' � � '
i '
50. Gas Release to Southern California Gas Co � � ' •
_ ; t
, 51�. CERTIFICATEOF'OCCUPANCY ' _. _., . . _.' . ' �;, :-
No. � ' Date t. _ . . ' ' ' ' i , � . . . -
\ '�
ly
noonessocauaoixc: 9qQ DARRELL ST
owr+Easru�Ei��+: HASSELER, ELDON W
�ooness: HASSELER, PAULA
944 DARRELL ST
COSTA MESA,CA 92626
APPL.MAIIAHiAU0PE55: ,
AIiCXRECT Ofl ENtlNEEN:
I� ANCN. OP FNG'S AOOHE55:
CONfP�CTOR'S N111E:
CONfPACTOR'S MAIIR�G . ,
- �1DDXE55: .
UNT:
�
ue. ra:
UNT:
uc. �a.:
, uxr:
LICENSED COMflRCTOPS �ECLAFITION: I Mroby Nim umbr penely d perjury ihet I em licemed under providone of Chepter B
�mmmena�q wil� Seelian ]000) ol D'nieon � at I�e Buaireu uM Pmleaeiona Code. eM mY lieenae ro in lull laett enE eMetl.
cmuc.no.: � � uc.cuss:' ' uc.No.: EXP:
ome:. ' ' cooirea«:
,
OWNEfl BUILDEH DECL�PITION: I hereby effirtn unEer peneYy M perjury thel I em uemp Irom �he GonVeqon Licenae Law �or IM ,
lolbw'v�p �eeaon (`�� )�1.5 Buaiwss eM Pmlesaime Code: Mry cry n oouMy wfiiM nyuira e pe�mit lo mruhucl. Mer. impraro.
demolmh, or rope'r eny elrudure, prior to ils ewaiwe, eleo reQuirea iM epplifanl for wch permN to file e eqneE eletemenl I�el M or eha
w licenaed W�+�t to iM pwisione d tM CaMreGors License law jChepter 91�ma�ip with SWion ]OW) d DHeion 3 d IFr-
Buainaa enE PrWmsione Code� or Ihel he or ehe ie axemp� ihxehan end �ha bavia lw Ihe ellepeE uempibn. My volelion d Seclon '
]W 1.5 by eny eppl' em Iw a permil wbjeda ihe eppliceM lo e wil penelry d m� moro �hen live huMred dollen j3500��.
Qi I, av ovmer W iha propaMy or my amployees wnh wegea sv thei eola wmpemation, will do ihe wwk, end Ihe eVudum i rwl in�anded
• «Meredbraebl5ectwn)oa4.eusiiwsseMPrdmsionecoEe:TheConireaonLioaneeLeweoeeiateDPMloenown«aProDaM
who buAdn ar imD�%'es IMreon, vM who doea auch wk Mmaell or Mnell or through he a her oxn empbyea�, pwkad ihm wch
' peovamema ere not inteMad a oHe�ed lor sale. M. however, ihe buiMinB w inpmvemam is eoN vmhin one yeer W mmpleton, tha
owrwrWitler will heve iM WMen d poviiq M or eha dk m� build a improve la �he Wmose d eeb�. �
� I, es owiror d iha propa�ry, em udusivNy mn�red'uq wilh licensad conVaclon lo consVud �he 0�1� (Seaion 1044. Businros end
. Prafesaiona Code: Tha Contredora license Law Aoes M apply lo en owner d popeny Ma WiIM or impovea ihereon erd who
convatls 1« eud� prqeda wilh e convmor�e) Icenaed pursuent m ihe Conlreawa Licenae L.ew�.
� I em eRemLpt/uMer Sectiom /y � B. 8 P.C., la ihis re%`� /f///� �//��.�,�/�� /�/ � .
Dele: ! � ZS—KS Owfwc . / �YGCF/",� �//L:V{qT/�(
i ao n..eM �nM ine� i em e.�.e a.�e u�enw�d me rea���ems d ce��omm Haenn ene seroiy coae seeons zsws. usa�. ene
2553a, end ihm I or any M1nure buiWiip «apenl will / will rw� (rircb aw) need io cwnply wih aeid ateta wdea eM iM req�iremanb br
e permX iwwnalruction a modifi a�bn han IM A'v�6t�epament Dinrid. RmkeMiel oonsVuaion eppti�aliona era ssempt Irom Naee
proWeions. , . . . ' , . ,
Deie: � ApqcaM: .. •
WONKEP'S COMiENSRTION DECLAFATION: 1 MreEy elFrm uMer penelly d perjury orre d ihe blbxi'p Aetlermone:
❑� i ne� d,d �da meim�n e canace�a d��� �o.an.�mure t« wone� comre�w�, e: n�oadee r« M saeb� s�ao a me �no.
ceeo, �« �n. pan«merce d ue ww �w.N:cn mis pertnX ia iavued.
❑ I have end xi0 meinien woMen'rompenseion inaurence. ea required by Seeim 3>00 d the Lebor Code. br iM peilormaMe d �M
wwk la whiM iNs parmn ia mued. My warkers' mmpnsation inwrencs fartier enE pdicy number ere:
ce„� '
. . _ awtvN�me«:
�(m;s �nro� ��d na ee �dared e m. re,mR �: iw one w�ered done� lsiool �, �as,.�
❑ I cenM �nm in tha peAormenca d iM work tor whcM1 ihia perme ie osued, I shell m� ampby eiry penan in eny men�r so m to
bxoma subjae ia the vroAara' compensetion levn W Celifomie. end eprea ihet A I ahauld bacame euEjea io tha waMeee' �
�w��� v�u�. a seao� a�oo d ma teeo, code. �.ne�� �onnwnn ownoN •;u, ilme p,ow,�a,,.
ome: nnw�c
W�miny: Nllun ro ueun woA'x�' eomysrueHon emx�ps b un6wlu( mtl �MII suD/wf m xnp/oyw ro ctlmlml pen�ltlu enJ
enu nnea w ro ar. ni.nd�sa rnoua.�e aarn lsroo,aooA �n .emuon ro rns co.r o� rompxu.rron, am.ps u povmsd ro. m
SeeNm 3)O6 0/ Ms Lebor Code, Inferest, en0 ettomeyl Iw�. ' �
CONSTHUC110N LENUINO AGENCY: I henby eHim uMer penelry o/ perN�Y �� ��� ia e consl�ud'an bMinp epeMy for �M
periormeMe d ihe v.oM Iw whirli �ha perml ia oweE (Sadan 309]. Civ. LI. .. '
� LENDEN'S NAME:
LENOEX'S10UPE55:
I ceniy thet I heva reaA ihc epplice�im end 9me ihet IM ebove iniormelion is conetl. I nprea ia compy wnh ell my end�wunry oMineneas
enE e�ete lews �ekivp to buikmg mnatruaion and MreEy eNlwrixa iepaeemetivea d tAo �ly lo enlar �pon �M ebove-meniioned poperry
������°������D�� ELDON HASSELER
m r� G,� R.%
' �"D.�-� oe,,
srene�ure ol Oxibr/neanvAPVYcanUComreaa
(515t<6.WP) Whilo-Buildvq 8 Selery; Oreeo-Fle; Cenery-pppFcenC Pink-Revenue; GddenradAseeawr
CITY OF COSTA MESA — BUILDING PERMI.T
PERMIT NO: B 07433'7. PLAN CHECK NO: N
PERM NO: B 0"74337
GOVT; N'SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: dTH
JOB DESCRIPTION, : T/OFF REROOF W/COMP SHINGLES SQ FT: 2,000
CLAIM VALUE: 2,000.00, CALC—VALUE: 2,000.00 GROUP OCC: R-3 /
COMMENTS: REROOF 17005F RESIDENCE W/COMP, SMOKE DETECTORS REQUIRD PER 91UBC
iflfiEiEfElEiEiE�lEiEiEiflEiElf7EkiE�lEfEiF�(-iEifiEifiE�EkiEiEfEiflE�lEiEiflFiE3f�EiE�EiE�E3E3EfEiE1EiE1EiEiEiEiEiEiEiE iE�1ElFiEfEiFiEiE�)f-)EiEiE3EiE , - "—
• Z O N I N GS ERTEHQAUCIKRSE M' E N T S'�1�!�KE pE�-�CTOR
----------- MAIN BUILDING ---------- — ------ ACCESSORY BUI���{��--
FRNT: FT : IN REAR: FT IN FRNT: FT ' IN REAR: r7 N
LEFT: ' FT ' IN RGHT: FT IN LEFT: � FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42235229 ZNE: . 'REF NO:�.;�
PLANNING NOTES>'" , vR
lit ( .
iE IE iE 1E 1E 1F iE 1F jE IE �E iE iE 1E�iE 1F iE iE 1E iE iE if if * 1E iE iflE iF iE dE 9f iF iF �)E 3E iF if !E dE if iE if iE 3E iE dE iE iE �E iF iE �E iE iE if iE iE df 9ElE �1E iE iE iE if iF iE 3E 1F'1E �E aE dE �E 1E if dE if
D E V Ei�,L O P M E N T S E R V I C E S R E Q U I R E M E N�T, S �
ZONING APPROVED' BY, DATE: !�' '
BUILDING APFROUED BY : DATE: q�G
APPLICATIQN ISSiIED' BY; DATE: I�,��Z� l�%
3E3EdEiEiEdEdG*iFiE3FiE*9'iF9f1EiF9EiEdFiE iF iFiE1EiElEitiElE'IFiE3�i'f�iE�TFi�iFiE3E
LEGALIZATION:N F E E S U M M A R'Y STRUCTUP.AL�SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 45.00 � ' .50
,PLAN , � SMIP/NON—RES�
ISSUE FEE
BUILDING—DIV—>. PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 45.50 0.00 0.00 45.50 45.50 ,00
' . � . . , ' . _ .
REVENUE DIVISION TOTALS--> COLLECTED: 45:50 t�VER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE .SMIP/TOT GR'ADING PLAN-CHECK
45.00 .50 ,
* 3E iE iE if iE iE iE iF iE 1F �E iE jE �E 9E 9FlE iElE if !E iE 3E if iE iE ik �E iE �E 1E 1E iE iF aE 3E �E iE iE iE iE iE 1E df iE iE �E if IE 3E 3E �E 1E 9E iE iE i61Elk iE 1E iE iE iE 9E iE af �f iE iF IE �E iE �E 1E �E IE iE
`I N U I' V I D U A L F E E B R E A' K D O W N ,
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2000 �REROOF BY VALUE RESIDENTIAL NOZONE 1.00 2,000.00
END OF FEES
_ �
;
� 01 C019Dt',63-t7�193E64 Y�iT ti.:.d3
Dy7E: uS�25/9� TI11E: 1#:20 '
�
. ✓ .�-
CONSTRUCTION AND PCANNING : �_ 2 �' ` i: -� .. ;, .- � •. .L & SPA
��Daxe Inspector ' " " ' Date Inspector '
APPROVACS Permit #�� � ' - APPROVALS Permit # �
- � - �r:
i. Temporary Electric�I,Service or Pole �; ,� 52. Pooi�& Equipment Location , - ��
� `� 2. So�l Pipe-Undrgrnd. �" ? : - 53. Steel Reinforcement � � � � - . ' � ' , � + r i
,�3: Electrical Conduit Utility-Undrqrnd..� ' f � �� 54. Forms- � , ' � ' .
� 4. Electrical Conduit-Undrgmd. , ' �. � - ` .� 55.� Electrical,8onding? � � - ' � �
,' '
, 5 I.,Steel Reinforcement : r _ � � ' N 56. Rough.Plumbing & Pressure Test •- ��
5 6. �Electrical UFEfl Grnd. ' � '� � � 57, APPROVAI TO COVEA�GllNiTE . .'-��
��''7-,Fooxings - - �' _ ' - 58, "Electricai ConduiFUndrgrnd.,, � � � �-.
. 8: �Foundation -` �., � 59. Gas Pipe;:G Undrgrrid., Test � -
�
� 9. Water Pipe�Undrgmd. � " � -' - ., � 60. Backwash �ines, P�Trap, O Undrg�,nd. ' . '
10. Structura� Floor SYstem � �_ � -. - ' 67..� APPROVAL TO DECK �
�
7 t. Property Sewer Line & House Cnnn�ection � _ -, 62. Backwash & RecepYorFinal , �
12. Sewer Cap � - - � , � 63.� Heater°& Vent�Finat � , - � '
i
13. Roof Drains . : , � y . . � >:•. 64.. Plumbing SVs�tem'� FinaL � .
74. ftough Plumbing - } '� ' - _ '= j 65.��Electrical-Finai ' �
i �
'' 15. Rovgh Eiectricai-Conduit � �. ^' � � - - _ f_ 66.� Solar System�Finai _ � � � � ,. ,
76. Rouqh Electric Wiring �'� � � - 67.� Fencing & Access Approval �, �,
77. Rough 1Niring Sign � ! � a . �66. APPROVED�fOR PLASTERING y
18. Rough Electrical-T Bar Ceiling i'� .. � �� 69. POOL/SPA SYSTEMS FINAL '� �-�
- 79.'Rough Heating & Air Condiuoning -�'- ' ' ' - ' " '" FIRE DEPT. REQUIREMENT � - �
- � - -
c
20. Rough Pactory Firepiace ._ � � _:' APPROVALS�_�. Permit#
21. Ducts; in Structure �� •� • �� � ' 70. Underground Hydro
22. Ducts, V¢�tiiating � '. 71. Product•Piping Q�Gas OOii
23. Gas Pipe-Rough & Test . � � 72, Underqround Flush �
24. Roof Framing � ��' ' ' - ��, 73.. Undergmd. Storage Tank � Gas ❑ Oil
25. Roof Shea�hing " �j�� �� 74, pverhead Hydro
26. T�BarCeiling (Structural) & Monocoat ; ' !"'� 75'. Dry Chemicai - . � -
27. Frame and Fiashiny . � , , c 76. Dry Standpipe �
-•28. Lathing$iSiding �� � � ' , - " "' 77,.; FIXEDSYSTEMFINAL
29. Insulation . � . �� � � r � 78: FIRE PREV. FINAL � �
�' 30. Dry4�all Nailing - � . HEALTH�DEPT. REQUIREMENT
'37. PlasterBrownCoat; - - - , � ^+ �79. FINALINSPECTION
32. Electrical,Powei MeterFinal � �'' ^�'80: FOOD CERTIFICATE ISSUED .
33. F.inai:Electric , - .. " 4 � ' � } Notes: - - � �
34. Final Heating & Air Conditioning � ' ' ' •. � � -� - �
r
35. Final Gas ?ipe Test . , � •��� -
- 36. Hood or CanopY . ' . . � � , � . �
. ''
_'37. Finai factory Firepiace , . _ �� � .
�.38. Final Plumbing ' .'�,��° - '- ---
'39. Water Service�Finai. ; � ~ti' . .
40. Gas Service-Fina� : i � �� � � �- , � � '
ti
'41. Solar Oomestic-Final � ` � ', � '
42. Backfiow Preventer � - " ' �
43. Backflow Irrigation. . �, . � � �
; 44. �andscape Irripation��System ' � � � ' - � � � � -, -
� 45.� Sound Attenuation," �� �, „ . • - - � -
�
'� 46. Handicap Regulaiinns ' � • ��• � � : - � � '
47., FINAL STRUCTURE &�BUI�fliNG �_�` q ��"� �� � � ` _
, 48.. FiNAI PLANNING . . , �; , :�'+ ' � _
� 49.� Electn'c Release to Edfso��. �� :i , n ,• � ' ' -
� 50., Gas Rele2{e to Southem Calito�nia Gas Co �" :�• ,- '_ • �
:51�CERTIPICATEOFOCCUPANCY . •� '
No. Date.
. ,
COSTA MESA BUBLDI6VG DEPART�IENT
P. 0. BOX 317
COS7A MESA CALIFORNIA
F
m
w
d'
H
N
C.L. OF STREET
' __�iPROP. LINE _
� 10 FT. FOR 60 FT. STREET
�
�
�
�
�
m ���
� IN�p
��
�
IW
�a
lo�
�a
_EY QR PR
6 '
tl
�
1
/
7
P, L I
PROP LINE
--��—=--�-------
C.L. OF STREE
Q � � I
�
w.�� �
�dw I "
4 p � (-.
� 10
C l� o C�
V L n FTI
�L� IO .Y �- �
-� c� r I
t�-iw Z
U � � �
�' ma i ,
�
I
------� ,
C+]
FT !
0 F S T.
EE
�
CITY
MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES—=----
MAXIMUM 6�FT. FENCE MAY BE PLACED ON SOLID LINES
I 5331 I
FOR APPLICANT TO FTLL IN�
BUILDING ADDRESS /��� ��L2r� � � t
O�vner �• .+J• �� s 3
Mail Addres� �-^-'�^ �+-
City C � ' Ph. No. '
— - - - - r `- - - -
Contractor et� � ��ec�ph. No �p S�"�
Address '%�y � ��v'""'^ ' C-'Y'r' "
City Lic. No. `��� State Lic. No. � Y�'ya' `�
Size of Lo - d- -� - -AP No - - - - - - - - - - -'
/
Setbacks:. C/L Stree+ �SS Rear `
�l�
Side Yard - Right Left
Type oE Fence �� � `� .�-�-�
' ' I _ '1 r
cEivE
1�� � � 6'� a
: DEPT.
)STA MESA
I hereby acknowledge that I have read this application and state
that the above is correct and agree to comply with all City Ord-
inances and State La�vs regulating building construction.
.
FOR OFFICE USE ONLY
ALUATION
5�
-�i-�� G
Permit Fee $-
Plan Check $-
TOTAL FEE $_
USE REVERSE SIDE FOR DETAILS
OW NER�gr1St01 �Stat85 ' 9� s DATE �-18-56 � -
JOBADDRESS 9�4 llarrell Street BUILDING PERMIT NO. 28�Q
GENERALCONTRACTOR $•V•Hunsaker VALUE $ 8,856.��
�or 93 e�ocK TRACT �R7� Single Res. w/att gar
. GROUP I& J TYPE V� ZONE RI1 FIRE DISTRICT 9R��
INSPECTIONS
Foundation
Plumbing, Roug
Temporary Pole
Wiring, Rough
Heating, Rough
�Heating, Final
Septic Tank or.�Ci
Lathing,ln
Plastering
Plumbing, Fin�al,
Plumbing, Fin,al �
Wiring, Final
Occupancy
FORM 210 3M 10-v'.
to
Out '
�
Fixtures Com
SUBCONTRACTOR
PERMITS ISSUED
DATE I NUM61
�
�
� _�=�.�osta Mesa Bnilding Departruent`�` `
��� P. O. Boz 3! 7 ?
�''� COSTA MESA, CALIFORNIA �
FOR APPLICANT TO FILL IN �
Building (� ''J� ..
Address ry� (/ /Z2,ELL. �/ •
Costa Mesa, California
Nearest / A
CrossSt. [�,ryL:� /� !��•
Owner 7.l(G/S % d(_.. �GTr9�1'� i
u�
Contractor J.
(AtWch Metes and Bounds)
SizeofLot �d%X �E,`nl No.ofBldgs
Now on Lot �
l�seof __ No.of No.of
Existing Bldg. I F�amilies I Rooms
Setback Line from 1 Rear Yard
Center o1 Strxt S� Side Vard Z��
DESCRIPTION OF WORH
New I� I Alteration I I Addition I
Repair I I Moving I I Demolish I
Building 77 j// No. of /
Size �� // ry+ Rooms S Stories
:�PPLYCATION FOR PERiVIIT
;�� BUILDING '
FOR OFFICE USE ONLY ,
,Receipt No. Permit No. ,
�� `�0
�Receiv by- Date Rec'd. Date Issued
1��/�-,�.I SG�iQ;.c�
�iiding
Address
Costa Mesa, California
Nearest
Cross St.
Zoneb� � I No. of I Typo-. /'
/\ Plans V
Approved '
by . Da
' ' CORRECTIONS
t
_ _ ... ' _.' _ _ . . _"" A
�ta�\ i :'?t ' . . �
- t�+J � y�t. 2
1 �.� r.•.�'i"� i d"i�' -- -- >
- �- -- -_ _ - - ' --- -- �
Covering S'�!/(G(_G I Covering �,[,�'/� A
Use of Ne ) �/
Building � f-,Q(�'�F f;4/yJ !%��,(JQ/�� Foundation Locatioi
Forms, Materials,
�_ � ��(- � Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply Lath. Int.
with all City Ordinances and State I.aws regulating
building construction. � // � Lath. Ext.
Signatureof �'��' ^y�"� �� •y/�—y/—
Permktee �i�C/ �1y6�� Plaster, Int.
Authorized Agt. (//�Ge1 � ]�///}lr,�/�� plaster, Ext.
Valuation . Fbnlnit Fee $ Z Z-��
Q` Q� O � Plan Check $� 7�• 00
$ u� O � �.• Total ?
Fee $ 3 J , �4
ain zo6 10-55 O. P. 6 5.
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�OWNER VESS�"�A. J. , DATE � (
IOB ADDRESS '' 7uu —ari'Cu o�z'eec BUILDING PERII-IIT NO.
GENERAL CONTRACTOR MorLi. 1riL• nlOCK VALiIE $ �=L•UU
AP. No. LOT 93 1'RACT 28%3 FIRE ZONE DESCRIPTION OF WORK RCdWOod FEIDCB �
GROUP TYpE ZONE �PLAN NO. 331 �
INSPECTIONS I DATE � SUBCONTRACTOR
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Final Gas Test
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PERMITS ISSUED