HomeMy WebLinkAbout920 DAHLIA AVE - Building Permitsl�0'JPESSOFBVILdNG: _ y�U� UAHLZP. AC' - uNr:
OWNEX'SNAYEIFpqWk NGUYEP7, T3ANH ' � FLOOD: AH-38
N( ,M;•:aooxEss TRAN, NGOC , ' '
920 DAHLIA AVE
CC,1 TA MESA,CA 92626937-?006
1PPl.WU11NQi1DONE5k . .
1qCXRECT ONENfdlFFP:
AIICN.OP ENG.'41DDNE55:
����T�g� PETRONELLA ROOFING
caxm�croxs�u�wc • ?626 NET4PORT
,�p�u, COSTA MESA
92627
110EN5ED COHrH1CTOfl4 DECLARATION: I hereby eflim uMx penel���yyyy
(wmme�xi�q xn� Sxtion 1000) d ONisian � W �M1a Buai�u eM PrMes�
cm ic. No.: 0 3 2 6 Q 5 uc. cuss: C 3 9 uc. r+o.:
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uc No.:
UNT: ,
(714)548-1645
A uc.ra.: 00960707
u�: 201
I em IiromeE urkx prwuione d Chaqm 9
m hll tace ard eHetl.
Oiu� EXP: 07/95
ele: � CaNmtlor.
1
O EN BUILDER DECIANATION: I hereby elfirm under penely W ' ry Ih I em xemp imm IM CaMretlon liroiue law la IM
xin0 �� (�� ��1.5 Buanesa eM Pmtessione Code: AnY GY a m iry wM1itli requiree e permil to mreM1uct. ellx. impwa.
demolsh. a rapeb eny simcWre, pnor lo Aa ewenca, elso mpuirea th epplicent r euch pe�mn �o file e eipewd eteiemenl thet he a ahe
n licenud W��� �o IM povieiona d IM Conlre�tore Licenae law Cheqm (oomme�rp xdh Sepbn N0p) d Owuion 3 d ib
Busima eM Rdmiwu Cade� a ihel he a eha u exemq ihereliuen iM " la the elbped examqion. My vidmion d SeUion
]W t.5 by eiry eppliraM tor e pmmil v�bpae Ihe epplcaN b e avil a m«. inm, r�a n�e�e ed� �sswp.
� I.avoMnerdlMpropenyamyemply�wawYhwepevsv�heixb ruetion,xilldolMwoM,enEtheal�uclurebridiMeMeE
w oRerad Im eale (Secuon'l044. Busineea end Profeeeiona Cada: Tha Camrepon Licenae Lew doee � epplyto en owrwr d qope�ry
who builEa or vnpovea ihereon, eM who Eoes such wak himeall or heneM or IhrouBh he a her own empbyeee, qwided ihet e�ch
impovemenls are nd inteMed or atleieE la eab. If. howwer, tha buitli�q a'vnqawneM b mM wilhin ore ymr ol wmpletion. �he
. o�.a�ue.� �n n� ine a,� a wa�ro na o..ne eb �a d,�b «�mo� �� �n. a„� d.��. �
� 1. m ovmer d �M MWsM. em extlusnroN conVm'rq xnh lioansad wnYactoia b wnetruq ihe P�lan (Seeun ]OM. Busi�e W
Profeseione Code: TM GmtreGore Liwnae Lew doea rat epply to en awrer d qopeiry who buike w impwea ihereon eed who
� mnvecb br auM Drol�s �^Ih e wmreGor�s) IicanseE W�ueM to ihe Canlreaas Lioensa law).
�. I em ezemq uMer SecYon: B. 8 P.G.1« the �eamn: . .
Dme: . owiwr: ' .
� ao nereey cenly �nel � em ewere w ena uMen�end �ne recuiremem. w celaomle Ikdih .�d sdery code seaiom ums. usaa, end
uSX. enE IhN I a enY �ura hiki�p aocupenl wi11 / wYl ml (dreb me) �4 to canph/ wIh eek stels mdea vM IM �aquiremente M
a Oeemuf«ewaVw.lbn a modifimtionhamlMA'r�a�yemem Dislriu. ReadamW mnal�utlion epG�'dbmen e�emMhom �hme
w�a.
ome: � - noW�� '
WORKEF'S COMPENSATION DECLIRATION: I Mreby effirm uMer penelry d perjury one d Ihe /dlovniq deduetiom: '� �
❑ 1 hew ard xY meiNen e wMirate d mmm�i to seXiiuurt br v.wkere' oompeneuion. m qoviEeE ta by Setlian �100 d iM leEa
_ /cade. la �M pa�ormarcw d Na v,wk la wFich this pam4 w iaaueE.
�heve eM xil meimen workeis' cvmpeneelion ireurenw. u rep.uired by Seaim 3)00 d tha lebar Code. M tM peitormence d tM
woM iw wi�ich Ihie peimn is ianueE. My w«kere am,penW ion ireurancs cemer eM pdiq number ere: ,
c,m,, te:.��ur�tau t : _ EXPIRES
. Pdiry NumDec � 1.� .� � 1 a.� �a '� Q 1� �� / 9 6�
,ac��..d�rn.comWNeermeo��;,rda�enu�e�eeeone ioo/arw�. . � �
nAy thel in ihe perlormerwe d ihe xroA for whch thie perme ie i u, I ahell n�T� eiry pereon in eny menr�er eo � m
bacome eubl� to tM v.orkers' comW�ae�ian lewe d Celitpnie. � �epree Na1M-I_�M�become wbjeq io the xarken'
com�\4n,aN�ion iom d Seaion �100 0l IM Labor Code. I fih comVN wM tMw vr iu�na. �
Dma: . J ����� AOWium:
W�m/nD: F�Ilun ro�ecun woilren'rompxwtlan cawnp.ls n1�wNl. • �NII suU/�ct �n xnplonr ro crlmin�l pxvMu �ntl
clvll llmi up ro one �u�MrW fMuanO Eolkn (5/00,OWA M a Itlon ro M ewt ol rompenseWn, Wmep� u provkkC br In
S�ctlon 3]P6 01 Ns Le6or Catls, Inron,f, siM ettomsy'� lsu.
CONSTflU4TON LENDINO ROENCI': I haeby dfirm uMar d ry �hm �hen'v e can¢t�udion bndiiq epency f« Ne
peAormance M Ihe work fa whidi the paimY ia osued (Seclon 3091, ' , ' �
- LEN�ER'S NAME: - � � '
LENDEN'S RDDRE55:
I cen'ily thet I heve read Nc eppl'ratian erd ume Oal tlro ebova iMarmNion n coned. I pme to canply wilh all rey ad munry adi��
eMstetelevnnWm wEuild�qcanavuctionudherebyeutlwraereqeeentetivesafihuarytoenteruponiheebove�mmlionedqopeNy
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CITY UF CUS'I'A MESA .- HUILDING I'EF29IT
PERMIT N0: P 073569 PLArI CHECK P]O: , N.
CONSTRUCTION TYPE: PERMIT TYPE: STR
PERM C10: H 072569
GOVT: N .SUPP: N'
PURP.USE: OTH
JOB UESCRIPTIO*] _. T;UFF RSTH 5 REROOF !,1/LIGN.T WT TILE SQ FT: 8,800,
CLAIM VALUE; 8,800,00 CkLC-t7ALUE: 8,8�O:U0 .GROUF OCC: R-3 ,/
COMMENTS: LIGHT WEIGHT TILE IC30#2093 E RESURFACE DECK E RE�IPISTALL RAILLING '
if x af iF if iE �If jf �1c # ir� iF+f if ic+c ic ih �)c ic 3c iP iF ff� iR iF �lE ic �E �ff j4 it #� # au � x�1(� if �N if +c x iF ac jc iF -)E x i4 � a: �N-u;F �rt a-.K. ic x� ac ac> �u a:+c a-.�c �c x ic iR 3t x>-M * i: -r
, 2 O N I N G R c Q 0 I A E M,E N T S
S E T H A C F: S.
------------ MAIPI BUILD,ING ---------- --------- ACCESSORY BUILLIMG --------.-
FRNT: FT IPJ REF�R: FT IP7 FRNT: PT IN REAA: PT iN
LEFT: ' FT IA7 RGHT: FT IP7 LEFT: • FT IP]'R.GHT: FT. IPJ
PARHING P.EQ; PROV;, 'PARCEL; 417.18335 'LNE: REF NO;�
PLANP7ING P70TES> ' .-:•
� e�w , . . �' .
ifiE'IEifi%ififiFifi%�iF'IE')i-ifY'V#f1Mif+4Y"YifY-'1EiF'Ni(�%ifihi�;'N�Ri���E iF'N'aF1F'K'Y'YiF-lf'X'if�lfliKifiF?E?fiF'jFiE')%iF'7f%i(�iFi6tiiFi:,if#:.1F'I�iEii'iii"r14iF
D E V E-L O P M E N T S E P,�'�? 1�� -�E�' R E{� U I R E M E D] ��;T S � .
ZONID]G AF�PROVEU' BY � ;�t : I vT DATE; ^? .
BUILDING APPROVED BY : ' Q DATE.: ��'%� '
. . . . i ; � . �— ^ .
APPLICATIUtI ZSSUED $Y: _� _ �""�""�' UATE; � 3J S�
jf*�t�:*+Eatit�aEiEx-ir-w-*t*r+jt+�FTriF+T�+'�iF���t�F�rtS.*�sFwt:%«7'.z.Fxx-7'+4.�YrF.�k+F3F�cu�f+E�ar-itacacu*.<-+. yt +F ,.a. •
LEGALIZATIODI;rI F. E E S U M M A R Y 5TP.UCTURAL :,�'GP ENT;Y _
HLDG PMi PLUMBING ELECTF.ZC MECHAP7IC FI3E?.--• SMIP/RES GRADIAIG
PERMIT ' 1Q8,OQ , ' 88
FLAN . . • - ' _ ; � , SM � /NOId-RES
ISSUE FEE ' ' � 3� �,,�' � ,
BUILDZNG-DIV-> PERMIT ISSUE. PLAN-CHECK TOTAL pR PAID TJE ,
TOTALS----> 108,88 0,00 O,U4 108,88 R,.1;08j.II8 . p
REVENUE UIVISION TOTALS--> COLLECTEU; ?.Og;88 OVER'/SHORT; ;UU-
BLDG PMT PLUMb2NG ELECTRIC MECHANIC FIRE SMIP/TOT GP.ADIAIG PLAPi-CHE�K
lOB.OQ , .88ry =�
*�cac**�txitr*��c*ar��i�i�ir��-+�jt�v���c*it*ac**x*i�*�t**�µ-�*�r*�x**.a*-.�t*r�a�;�r'�**�* �.v.«+ra+�<*��+r�*x*
I N D I V I D U A L• F E E E R E A K�D .Ol'4J'N
' � �'�
TYPE QTY U E 5 C R I'P T I O Dl, UNIT,,.�COS-T TQTAL COST
SFP. 8800 REROUF 9Y VALUE RESIDENTIAL DIOZONE :h00 8,800,00
END OF FEES +. �
. . . � {: � � . . ,
i
� . ' � ��y'� �
h� St
�1 Ou133C�ib—�D183flS6 T+CF�J' �103.33
�ar�: osiaa'rQs TIt1E: i5:35
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Seiey; GreerFb: Cenery-Appiran�; Hnk-Ra.enue; GolCemob-w+�eaaar :.
�.�_. � . . .. d..._r- �
\
n
� MN$TRUCTION AND PCANNINu �,..� �' , � � , ; ;, ,- JL & SQ,Fi', . , �
' r � Date inspeetor � i� ��i'-" ' 4at� Inspector
'�APPROVALS Permit# - APPROVAIS �Perm�v#- . ,
. S, Temporary.Electrical SerJice or. Pole �� .. '. �52: Poo� & Equipment Location',� ' �
2. Saii Pipe�Undrgmd.' . � � 53. Steel Reinforcement ' ��+ _ . •- ' ', ` 1
3. Electrical Conduit UttiftY-Undrgrnd.�. _` � . 54. Forms ` � '� � - --!� �
4. Electricai Conduit-Undr rnd. ' ' ��' � ' � ' ' - � - � � , � I
9 �:...! _ 55: Electrical Bonding . n I,
5. Steel Reinforcemenc � `'� ' . - , - 56. Rough Plumbing & Pressure Test . � � � � �;, �
�
6. Electrical UFER G�nd, � � �' 57. APPROVA� TO COVER�GUNITE -
:� .
Z Footings . � , _ ' -� _• - � 56. ElectricalConduic-Undr md. '• �`•
, g �� � i
�
8. �Foundation �� � - � 59�. Gas Pipe,�i7 Und,rgrnd., Test � - �� �
9. lVater Pipe-Undr9rnd. • �, --' � 60: Backwash Lines,�P:Trap, L:��Undrgrr.d��� I �
'\.
10. Structural Fioor System � - ''! � * .:"�- _ t61. APPROVALTO�DECK�` �_ _ � ,' �.
1 i. Properry Sewer Line & House Connection � - 62. Sackwash & Receptor�Finai - • .
12. Sewer Cap � - � 1 `63. Heate'r & Vent�F�inai ' ' , r �
.
13. Roof Orains �. ��• `� - 64. Plumbing SYstem ��Pinat �
14. Rough Plumbing � . _.�' �� " 65. Electricai�Finai � �" �.
15. Rough Elecjrical-Conduit � � �' .66' Solar SYstem-Final ry. �
. �,. . . '.tiJ
16. Rough Elec[ric Wiring . � ; - � . � � � 67. Fencing & Access Approval } � ' ` � � ,
77. Rough 4Viring Sign `� �, _• ' .68: APPROVED FOR PLASTER�ING � �
l_
78. Rough Eiectrical-T Bar Ceiiing �� �' � � 69. POOL/SPA SYSTEA�S FINAL -' ` � i-J .
- 79. Rough Heaiing & Air Conditioning - � � ' � FIRE DEPT. REQUIREMENT - �
20.-Rough Factory Firzplace APPROVALS Permit#
21. Ducts, in Structure � . 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � � 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storaya Tank O Gas ❑ Oil
25. Roof Sheathing (�,. f_ � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemicai � ' � '
27. Frame and Flashing 76. Dry Standpipe �
28. Lathing & Sidin9 ' 77. FiXED SYSTEM FINAL
29. Insulation • 76. FIRE PREV. FINAL
3�. Drywali Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. PINALlNSPECTION ,
32. Electricai Power Meter-Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' Notes: �
34. Final Heating & Air Conditioning .
35. Final Gas Pipe�Test . ( j _
36. Hood or Ganopy ;- '
.-
37. Final Factory Fireplace 1
38. Final Piumbing '�
39. 4Vater Service�Final �
40. Ga5 Service-Final -
47. Solar pomestic-Final
42. $ackfiow Preventer � �
. -43. Backflow Irrigat(on q L �^RS
44. Landscape Irrigation 5Ystem � � � �`� �� � -
45. Sound Attenuation � ._ � w�{--
46. ,Nandicap Regulations � � �•
a7. FiNAL STRUCTURE & BUILDING „�_QS �W�
48. FINA�PLANNING �.''
49. Electric Release to Edison ,__.--• .
50. Gas Release to Southern California Gas Co ��
57. CERTIFICATE OF OCCUPANCY ( -
No._ Date �
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920 Dahlia .lvenue ^s � � �� ` t t
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,*; A building perinit'has been i'ssued L'o,AuEoina[ion. Pools'to construct �
a private swirtmiing pool�.on your;property �,f .` - '�
. � 1 . `�a. 1 .�� µ 1 a 1, k ��R � '. ? , Y
t In order`'that your pool'will b'a safe'one nndwfor Che�'purpose�of '� �` , ;.
Y � advising;you of�your responsibil. y segardLng,,the*requirement;"s,of �,� .�-
''' � :Che,Gosta Mesa''Municip&1;tCode;'.'we�refer;you to�'.Section';8107� a;'copy '�' '�°" '� i;
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" � :of 'which is attachedY"'`_ �-,`a `�-, -' _,: ' ' �" E _
Y ' � . �. � d � �. n a .,; � . . - _, .
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"' � This leEter is di'rec '-�Co you in order.;,that you will beraware`'oF our; f ��
. ,
ordinances and cen mak complete safety check",of youz'pool area'f `
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r ' � . n 5' t „��• r x, Je �^�..,_;�" . . Sincerely .yours� � _ F 3 '«A s '�, � '_
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TESTIN6
July 5, 1973
Laboratories ��f ��«t�=z=�� �'�<<<f�,���«_, �,�=.
P.O. 90X s] . 3Ji0 P.��"?OP� `Nf.Y . IO�JG BiACH. CALI=. 9�Gi . �713� <2c-i3i5 . �PJ?� 5_'o-2?BS • ��14� A2&h<3P
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Examination: SC73'4453
,COMPRESSION TESTS ON GUNITE CYLINDERS
Mr. Jack Hubbard
3106 Ostrom Avenue
Long Beach, Caliornia 90808
PROJECT Swimmi�g Pool for ROBERT BARRY.
ADDRE55 420 E. Dahlia, Cos[a Mesa
SAMP�E FROM Shallao End, Deep End, Bond Beam
ARCMITECT
FNOINEEP
farrell T. Miles
Mix 4 to I
DAiE CAST 6-27-73
DATE TESTFD 7-4-73
CYLINDER NO. 1
COMPRESSION . ]—Day
TOTAI LOAD, LBS. 91.000
CONTRPCTOR
Automation Pools
SUBCqNiN4C10Y '
Enterprise Guni[e Co,
SPECIFlED �
STRENGTH
7-4-73
2
7-oay
91,000
SLUMP
2,000 psi
7-4-73
3
7-Day
I11,000
VOUNDS PER SQ. IN. 3,355 3,355 3,925
SIZE: 5-7/8" x 1z-I/z" 5-7/8" x 12-1/2" 6" x 12-3/8"
COMPIIaNCE 7-day test complles with spec(ficatlons.
MADE pY
CYIINDERS Lou Bennet
oisraieurion:
cnera Mesa BIdg,Dept.
Mr. Jack Hubbard - j
DEIIVERED BY
Dave
RECEIVFD ON
6-29�73
��1fLD�V��r, SqFETY D�;���;.
JUL 9 1973
:1t: :�.. ..,_: �;� ` �' . _�. .� .
_,:
�Ll RE✓04T5 1PE SV9MIi1EO �5 iNE CON�InENiI�� ✓�O�E4I� (]i CLIfNTS sIJTMOPILAlION �OR VVtlL���}ION O� OUR HEPOFiS. CONCLVSIONS, OR EA.
iR�CTS �FOM OR RFG�ROiNG TNFM i5 uFStaVCO Cf�.C'�G �^. .v+ � Y�on90'J�1 s5 � MUTVI.L FHOiGCTIOH i0 CLIENtS. iHE PUBLIC �NO OU95E�VE5.
330 12
r,.,.-
CITY OF COSTA MESA.REQUEST FOR OCCUPANCY
TRACT N0. I DATE I �
LOT N0, �u'
The developer of the above entitled-tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The und signed, by executing this agreement, acknowledges that
h the i �_ advised that this tzact has
� y �re)
not been given ina inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval iahich were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless from
any claim resulting in dariage or personal injury to the undersigned by reason
of the aforementioned.;uncompleted condition.
',I .
�,
, , R�
�i
, �
' � • ' MAY 1 �,��.:�197� �'�'
,� ' Ah9'�, , ' " Pkf:' ..
7i8i9i10���ii2ili2i3i4�5i6 :
�� /
1 )
��'�
a
representative
'. BY ' /�-[.t�GCv /,c//,G �i2�
' Lender
. . , , - S, �r;. . . ..
� . ,�I: - . � ,
ER
�INSPECTIONS
� Pool Location
Forms —
Main Drain
Steel Reinforce
_�`Elec. Bond
ApproVal to Cover'
Underground Electric _
Gas Piping Test
Filtering System Lines _
Backwash Lines and Recep.
Electrical Final _
Heater and Vent Final
Filter System Final
Backwash and Recep. Final _
-- Y.!fle�. 1
DATE
BUILDING PERMI 0. 36782
DESCRIPTION of WORK private swiu¢ning nool _
FIRE ZONE VALUE $ ly $p0.00
Date GROUP TYPE ZONE
�G' SUBCONTRACTOR PERMITS ISSUED
Date Number Si nature
Flectric � n
'�•%� � c-ncn.-F , �/cr � -f�-%3 �G� -� - - - -- —
5 -73 / �
�Plumbing
�,r�rG�sn, -/_ 3 .�
i 73
. . � .. ' PA10 i4ir*Q
l• 367�2 �JUN 12-73cnsa�01001# 4�i.00
�: .
'� COSTA MESA BUILDINGSAFETY DEPARTMENT � �, . . -
� � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 �- � �- ,
- , , APPLICATION FOR BUILDING PERMIT -
. For Applicant to Fill in Completely � .
RECFIVEJ}BV D TERCEI D TEISSU D
, BUILDING A �( � �n' L�� ��' � ,�/
' ADDRESS �/ ' /.�. I /�JNG%N T� —/ / � �
P T
. OWNEF � 0 F -%' aAlz�.l �� � A.P.NO. ' . . . .
MAIL � ' " BUILDING :
Z .
AODRESS O �� � A F� L/A �+DDRESS O � D� � .
W W �� -- TEL. 7RACT LOT ,BLOCK
. d U CITV O$�/4 �CSa � NO. . .
Z J
ZQ .CAN5fRUCTION CpI' /�eC� . � W" ADD A P
ON LENDER r� - - .' / '. -
v
am
J7 BFANCH �QW'NG�� -
J (n , . ,� .. OWNEP O C`i `
' a w ADDRESS ' ` . -• '" � .
0] J - ' ' � � VAWE ('/ (�/
m ARCHITECT TEL 3 SE J�� SLU/ 7.OD S O
Ja ORENGINEER"`ARR L 7. f9tI�5 N GS.S ��E.�
U N ` ('� ` � FIRE" • �
. wK ADDFESS �O/O..S /�tlLf✓ C �+Q � 20NE. TVP � ROU '
J O . .CONTflACTOR /nU� %yJpYtlG, / p o� � _ByPROVED DATE � �Y
m� laDDRESS pZ J3�p G/C �QZO :�Y� ' � " � � ' �
w w � TE�. �b �ONE,' NO.OF USE OF NEW ��/(f '
ZF CITV �L TO-rCU ' NO. �OLs-�YY ' . PLANS BUILDING �/ d .
� STATE / - ' CITV �^ '+. VARDSAPPROVED -' ' VP.RDSAPPROVED
N 2 LIC. NO. 2�p387O • - LIC. NO. ' MAIN BUI�DING ' ACCESSORV BUILDING
�� SI2E /� ' NO.OF BLDGS. (FROM C/L STREET) .
' OF LOT T K�D � NOW ON LOT FRONT FT. F
VSE OF ,Q
EXI5fING BLOG. �� S. � S((// R?r((/j/ /' �n � SI E FT. � S T.
� SI2EOF �S.n,3G No.oF .� ,. ` . . . -- �/
� Z NEW BLDG. ROOMS STOflIES L SIDE FT. F �
' U EXTERIOR WALL - ROOF . � . . � �J
COVERING COVERING' REAR FT. �% FT.
J USE OF BUILDING AND WORK TO BE PERFORMED ' DISTANCE BET. BET. MAIN &
d - MAIN BLDGS. ' ACCESS. BLDGS.
a
Q � _ - VAR.# DATE '
O C.U.P.# ' /'� APPROVED
� r � APPROVED 'Y� '
� �
z' . . .. . .. . .
�
UI he�eby acknowletlge that I have reatl this application antl state ' . STATE
� that the above information is correct and agree to comply with
� all laws regulating builtling conztruction, antl I shall not employ � 4,% J�
r any person in violation of the workman's compensation laws of O� V
y the State bf Calitomia. ' , ' � . . � � �
zI hereby certify that I am properly licensetl as a conttactor under SQ. FT.' ' T/�( p
' Me State of Califomia Businezs and Pwfessions Cotla, Divisicn 3, THE AMOUNT SHOWN UNDER VAWATION IS FOR �
Chapter 9, and.that such licanses are in full torce and etfect, or 1� THE PURPOSE OF'ESTABLISHING A PERMIT FEE ONLV: m
. am eKempt from U��e provisions ot the te of California Business � Q '
VALUATION - � � �
and Professions C ivisio , C r 9. � ' PERMIT FEE 5 �
/�,�/% 7
Signat o // /� � ✓ - �� � m
� Permittee . $ �f ,X� '� PLAN CHECK $ . � d E
Authorizetl Agent � . . / (f � / �, � O . LL
� TOTAL�FEE $ "%�
- .. :...
; ��
. 66 . P ; ra4o ' �---^'�—'_-•_
� , . f\U� 15=7'ca,a�Q,1015�` -**'� 1 �7:Z4
^` 3500� ,
; • � ^' ;>�- �
� � COSTA MESA BUILDINGSAFETY.DEPARTMENT� � �� � � . k ' -
- � �OLB 'P.O.�BOX 1200 . COSTA MESA CALIFORNIA 92626� � � - � • . . ' _
�.
� . . - - - -. - Ap LI �ATION FOR BUILDING PERMIL �� '
' ��•- ���, � For.Applicant to,Fill m Completely "., �R cei E ev � oarE��aeceroeo
. ' DATEISS�yED
evi�oiNc �� - Dahlia`6veriue,, �2� -/y=7
ADDRE55
" . - . _"' ' , ' "y. • . . . � � PERMILNs .
. owNeR�'Larwin Southern� Calif: ; Inc:..�.`"- "•PiNO� �- �- _- ' ``` Q �
. MAIL ' � - .' . � . - - BVILDING . � • .
�
- � ,�ADDRE55'-+ 6QrjJf \7e{�[llTfl-$LVd � ��. , + `� ADDRESS �
a-U CITV �,ERClilO Ca11P'. .. N09HC); HS9O ,; ' TRACT [,. - LOT(p {a BLOCK�
zQ �CAN5TRUCTIOf� � - � � . NEW A D�ALTER� P y
', O � . �LENDER Larwin:Southerm Calif., ,�, � .
- n:m . . . . - . ., � .
' �� eaaNCH 16255 Ventura Blvd " ��J '1 //��
JN. . ^ - _'. . . . - OWNER� �� PU�!�/V��l./- - WG� '.
. a W .ADDRESS Encino� -Calif.' �•� - �- � � � � � . A�uF .,, ��� -
'• JQ ARCHITECT . TEL � SE' �3'.� 5.._3-`� ..
ORENGINEER �'I+aTWln ' ' N 273-G4�64'
U'tn . . � .. . .FIRE . . . �. . . . .
'Z a' ��'� � � � � -ZONE:� . TYPE� ROUP
� W�� ADDRESS 9100 Wilshire Blvdc _
aw . . _ . . �. p. . .
� APPR /�
W Z 'CONTRACTOR a BV ' ATE� /'
JQ . _ . _ . � . � . � .
..m .�. : • : . . . .. �' ., . ..',
��' aooaess i6255: Ventuia Blvd. -,,
w w :.TEI � ZONE NO OF ' 'USE OF NEW�� r AJ
,. ZF CITY Encino,��Calif. � ,;��No:986-8890,� � Pu+�'� BUILDING ' � �,a'
'� w � � 'STATE . �� � , CITY4 ��"� ,YP.RDS APPROVED, ' . VAROS APPROVED. -
'�� uc: No. 191311 LIC: NO B 1 . . MAIN BUILDING. . � ACCESSORV BUILDING '
�O� � - � � �� . (FROM�GVSTFE T)' - - � ^
_ 512E , .. . � ":: NO. OF BLDGS.. � . " ' ' .
- OFLOT - H�F X %% ' NOWON:COT � 'O, . FRONT+ � .^�FT.
'.. .,USE�OF ' .;.'.. '- .�.. ',. .! ��rv.nr.. .. , . .. . '� ^.' � .�" '." . .. ..
, .. . EXI5TWG BLOG. . . . ' � S FT. . . . ' .' FT. " �
� � � N SIZE OF-� ,..� . NO.OF •s : . . :. !" . . '.� � , ' . - ' ' -
Z M NEW BLDG .235�1 ' ROOMS � STORIES <�L �: L SIOE . . FT. �+�FT '
' " a pEXTERIOR WAL � ::. '. ROOF. . �.. .. .� � �' : =r:- . ,i? � �
� ' � V • COVERING '�CLLCCO COVERINGWCl. ;SF11R Lf . REAF �' ' T FT �- "FT. ' .
' ��l � , USE OF BUILDING:AN�-WORK TO BEPERF.ORMED �Y�� ` ,DISTANCE BET.,� " �BET.�MAIN &'.:� ,' -
„ ' a - .,'a�:' ' � p _ " �MAIN BLIX'>S. ' ACCESS: BLDGS� ` �
a - . VAIi. # ' DATE' ' � ' .
..'"�0;: '', u,.`� y . � � ., ��� - ' C.U.P � �. APPROVED� ' • � ,
r .. � , . �� . • ' APPFOVED �- .
•' v�, s'n e amil dwellin � 'STqTE.; �
.
, z . . . .
. • . � ..
. . .
, , . _._ , . , „ . .
O � re � �-�
' ' V� ' I nerebv acknowledqe mat;l.have�reaa�mis;application ana state '�HOLD FOR�.SPECIAL RE� �T � .
- ' ffiat t�e.above�informatioo'is correct�antl.,agree to.comply with�- ._.. �
'•�' 'ell laws'�regulating-builtling consttuction, antl fshall not employ � , '
:�. .,any person in violation of�the workman's-_compensation laws ot
� the Stat¢ of Calitornia. � '�' � ' :� ' '�' m
�` �
' z '. I hereby certify.that I am properW�lmensetl`'asacontrectorunder' � SQ:'FT: ��! � T% - ' � o �
�, ���ffie State ot California Business antl� Protessions Cotle, Divlsicn 3,� ��THE �AMOUNT SHOWN UNDER VALUATION'IS FOR
. Cnaptar 9„antl Nat such.licenses are'in full force and effect, or I �THE PURPOSE OF,ESTABLISHING�A PERMIT FEE ONLV: m�
��, 'am exempt trom ttie�,provisions of the�State'ot CalifOmia Businass' - .4 � � ¢ � �
. and-Professions Code, Drvision 3, Chapter 9. `�� �� � . " VALUATION- �� - �� . �5�' ry ,
L, , _ - PERMIT FEE $�� � .
. - SiB�ature o ' ' - ' � •� �� ��{{7. m
- Permlttae ��lii�.� � - � D ' .DOWHS� $�� /+� , PL4N CHECK S 'L7 . �/ E � _ '�
y ..
73- �
' �.Auffiorizetl Agent . . � . � . �� .. � . . , LL ..
- TOTAL FEE_ $' '