HomeMy WebLinkAbout953 DAHLIA AVE - Building Permits�j
-'LOHESSOFBVILOWO: -953 DAHLIA,AV ' uNr: �
a�''�ksr�wE�Fw�w":",GOTT, DANIEL JAMES TR � FLOOD: AH-38
eooness 953 DAHLIA AVE
COSTA MESA,CA 92626 , ,_.
�t.:556-9210 ,
�rv�. �uuNc eooxess: - _ . . . -. - . -
�RCNRECT OA ENtlNHN:
ARCN.OH ENG.'S ADDPE54: ` 1
uc. ra.:
unr:
ca�mAaarsxu/e: PAOL GARCIA ( 714 )774-9036
cwrn�crorrswuur�c.1506�,i�_OAKWOOD LN , -
�moxess: C.M., . "" ���� CA u r+o.: 605061'
91709 .. uNr:
- LICENSED CONTNACTOXS DECIAP�TION: I hereby ellim uMer pere�y d rjury Ne1 I em uMer pranabna d Clapm e
(mmmendnp v.ilh SecWn p000) M DiHebn 9 W Ihe Businew end PMeeeia Gode, enE my li ie in full brc .
c no.: uc.cuss: �-99 uc. 60506 P:
o a: `02 —2�-'i �—� � com�a«: � - � . .
N BUIL�EX OECIANATION: I hereby e1F'm uMx penelly d perjury ihet I em exemq Irpn �he ConVepwe Limnae law Iw ihe
inp reason (Sanion ]031.5 Business and Prdeaniona Coda: AnY cilY a counry which re9uirea e pa�mn to�omavun. elim. imprava.
demde�, ar ropeir eiry simcNm, prior to nn heueMe, eko requirm ihe epdicent br euch permil �o fib e eigneE slelement Ihm M w ahe
ie �icenaee wnueni io ine wovi.iom al me can.mun Liume l.w �cheai« v(aommmanv wnn seaon �oao) a oNebn a a iro
Businam eiM Prdeniona Code� or ihei he or ehe ia aaemq Ihxehom end Ihe besn Im tha ellepad w�amp�ion. My violelon d Sed'on
)031.5 by enY eVd�t la e permil wbpde Ihe apWcam io a wJ penelly d iwl moro Ihen iNe huMred dolleea 135001),
I� 1, es ownar M ihe propany or my empbyeee wuh wegea es �hev eole rompanution, will do ihe wak. end �he airucwn'v � intendad
«ofieretl br eeb ISecoon )o1d. Bu6m� eM PMmeims CoJa: The Conireeae L'wmee lewdan rwt wNito en owmr d MoOeM
� wM builda or impmvea therean, eM wM10 doea euch woM IimmM a henetl w �hrouph he w Mr own empbyeee. providad thet aucA
imprwamenls ere not inteMed a dlered 1« aele. M, lawever, lhe buiNi�q a impro+emen� u aok vrithin aw yeer W complelon, IM
own«buikar xill have tM burden a Oro+iM M or dw ek m1 buik «imWa'a 1« IM W�V�e d eab). .
�� 1. sv ormer d Iha propaM. em eacLmrvaM ����q �� �icanxA canvectare �o conmua Na piojaq (Sedion 10aI, Bwimes vM
PMmabm Coda: The Goniredae lironse law Eoee ral eppy lo en oxinr W propsM ���da a impwa Iheraon eM Mw
�convecte iw euM prol�s �h e conlrepor(e) Ibeneed punuem �o IM Conlredas Liceme law�.
� I em erompt �Mer Secuon: B. 8 P.C., br iho rsesan: �
Date:. ' ' 40wnu: ' •
I Eo hereby cMily Ihet I em eware d eM uMentvM tM iayuiremanb d Galilomie Meellh enE Sefety CoEe SeUbne 25505, 25533, vM
Si
25530, enE thm I a eny Mun buiki�p aaupeM will / wil iwl (areb aw) neeA b eanply wlh eeid atma eodp ard the epuiremenb br �
epem�ilbrmnewctianormoEifmtionhomtM�i u3Tyl�epamemDinria.RenidentielcpMrupionappicatiomueezemptiromihew
aw;.�,..
oue: � AVvlceM:
W OFKEN'S COMPEN9ATION OECLAPRTION: I heroby e/firtn uMer penelly d par�ury ma W IM Idlovrirp dstlumcna: �-- �
❑ IhmudwilmeintenacMNktledmnaeMioaetlirouroMwvke�e'wmpanWbn,npovidadfabySepbn3]00dlMlebor
Cada, lor Ihe pe�ormence N Uw eoik lor wMch Ihia pe'mil ie imueE.
❑ i n..�..�e.�� �m� wo�w� �w�.mo� ��,..�..... �a���.a M s«�� e�ao w u» i.e« cod.. m, ine o�«�o. a in.
wak ta which ihia permn ie iuueE. My waM�e compeneetbn in�urencs mMar eM poliry numMr ere:
Cemer:
' Pd'cy Numbar:
.(ihia pction neM riw be romdNed / UroW�)'n /a aro hvMreO dd�)sek .
I ceXty Ihet in Ihe peiformance d tM work Iw whrh thie permn i ued, I ahell n ny penon in eny mennar eo ee lo
becoma wbya lo IM xorFme' canpenaelbn kvn d C' e. entl epma thtl i I Mouk Eecoma eubjq �o �M worksrt -
ompe ution pmviaione M&edan 3100 0l lhe Labor COEa, Mell lathwnh mmpy xilh Hroae prw�iaione. ,
�e �--iL— l'% i! nodicem: � .
em/n0� F�llun b securo woAar�'romp�nutlon eov�rep� Is wNwNl, entl LWI wDNcl �n �mp/oyn fo MMiul ps�uMN an0
clvll nma up ro ons hunareA tMua�rW tlollen (Sf00,000A �� etltlltlon ro M� ewt o/ wmpxwflon, Oamep� �a pmv/4M ror In.
Sxtlon J108 0l M� Lelor COM, Infenal, mtl etromsy'� Isu.
CONSTPUCTION LENDINO AUENCY:� I hereby �rtn urMer panely W parlury �het tlare ie e mnnrunim IenEinp epercy br iM
pen«meMe d �ne wax �« wnkn mu v�� q�•�•d (s.eid, 30s), civ. q.
LENDEN'S NAME: �
LENUEP'S AUDRE43: '
I caNly Ihei I hew read ihn epdk��� � mde that Na ebove inlametion ie m�rtcl. I epree to wmply wilh ell dly enE muny ordinvKes
� endeia�elevnmleth9lobuiMinpconelrudianenEMrebyeuthorrzerepresenlelivead�haarybemarupaniMebwe�menliorwdpmqny
I for inapedion v�rpwea��L G�iC IA .
�
oe�,: �—�J —9G
(5151i6 WP) Whilo-BuilEiip d Selery; araeo-Fle; Cenery-ApPlicen�; nk-Rwenue: GOWenroE-As�mear
_,,_ .,........._ �' A_i _._CITY_OF COSTA,MESA_,=. BUILDING ,PERMIT_,, � "• _ '
� . / -., ,, ._ .. PERM NO:,.B _ 07652"
PERMIT NO: B �._076522 ,_ PLAN CHECK,NO:. �.., , N .'.GOVT,:,�N SUPP.: N
CONSTRUCTION TYPE:.V-N PERMIT TYPE.: STR ;�. ..,,, ,.PURPOSE:'.OTH
JOB DESCRIPTION : T/OFF , RESHEATH 6 REROOF.W/COMP. SHINGL SQ FTc 3,395� +
CLAIM VALUE: 3,395.00 CALC—VALUE: '3,395.00 GROUP OCC: R-3 /U-1
COMMENTS: SMOKE_DETECTORS ARE RE�UIRED 'IN EVERY BEDROOM 6 AALLWAY
�+t�-ie�at*it*atat*�*it**+e*+�ataE�t�t***�tit�tit�t etit**atx�et*it**at**+r*iE�-at*******f�it*atet�**�t**�tatf��-x�*�**
. _._., 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,HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; _„_f'T. '? IN. REAR: FT IN FRNT:_ FT IN REAR: FT IN
LEFT; --FT"cS: ;IN RGHT: FT , IN � LEFT: , FT , IN -RGHT; FT ' IN
,
PARKING REQ: PROV: PARCEL: 41218349 ZNE: REF NO:
PLANNING.NOTES> _ __ _ . _
,CY: � �:
!E 1E 1E 1E 1E iE 1E 1E iE 1E K fE iE.1E,lE 1E 1E 1E 1E 1E IE iE 1F 1E 1E 1E 1E iE iF iE �E 1E iE 1E 1k if iE 1E 1E 1Elf IE 1E 1E�E fE fE 1E iE 1E 1E iF �F ik IElElF 1f 1E iE iE 1E iE 1f 1f 1E 1ElElE aE 1f iE if if If 1E iE fF 1E
D E V E�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.APPROVED BY : ' _____. DATE: �'a / /
e
DATEc �
LEGALIZATION:N 'F-'E E S U M M A R Y-- STRUCTU
BLDG PMT PLUMBING` ELECTRIC MECHANIC � FIRE SMIP/
PERMIT 63.00: ,
SMIP/
PLAN _
ISSUE FEE
:Y
GRADING
HUILDING—DIV—> PERMIT. ISSUE PLAN—CHECK TOTAL PAID ' DUE
TOTALS,---> 63.50 0.00 0.00 63.50 63.50 .00
REVENUE DIVISION TOTALS--.> COLLECTED: 63.50 OVER/SHORT: .00
y, BLD63p00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TO�T GRADING PLAN—CHECK
iE �E IE iE if iE 1E 1E 1E 1E iE iE fE iE 1E iE 1E 1E iE 1E iE 1E IE iE iE 1E IE fE fE iE 1E 1ElE 1E iE iE 1E 1f 1E ik 1E �E ff iE �E 1E fE �E 1E 1E �E 1E 1E'lf IE iF 1E �E 1E iE 1E 3E 1E 1E fE iE 1E 1f iE 1E iF iF If 1E 3E'lE 1ElE 1E
_ 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
SFR 3395 REROOF HY VALUE RESIDENTIAL NOZONE 1,00 3,395.00
, END OF FEES
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_ _ . , - l--• ':� ; � - - � :. .. POOL o oP - �♦ -- ' . , .
`�� CONSTRUCTION AND PLANNWG�' }- ` � : :: v Pi . , -
Date_ Inspector .r Date Inspector, '
APPROVALS- Pecmit #� ' r f - � :?APPROVAI.S � Permit # �� - -
�
- 7. Temporarv Electrical Service or Pole � . ' �" 52.� Pool & Equipment Location �f _ , . ; �'
� '-2.' Soil Pipe-Undrgrnd. � . ; 53. Steei Reinforcement � � � 7 � �� -
t3.ElectricalConduit'Utility-Undrgrnd._' � '�' � 54. Forms � - , � � , • • w • .�
'��"4.-Eleye.trical Condui't�UnBrgrnd. ' . 55. Electricai Bonding' ` ' . � � - � i � �
: t5=Steei Reinforcement y, , � 56t Rough Plumbing & Pressuie Test " � � � . �
� 6 �lectricai UFER_G�nd. ' ' ' � � `' �� � ; 57. APPROVAL TO COVER-GUNITE . � ��
' ��7,.yFootinqs � `-' i �. �i� � - _ ' � � � 58. Electrical Conduit-U_ndrgmdr ' ��
_ •s-= : ._ . ._ i r.'.
°'s�8?7Foundation y . , � � ' _ � 59.' Ga's Plpe; � Undrgrnd., Test� "' � '
j� ' . .
�';9. Water Pipe-Undrgmd. j ' �.�' - j ' , .; , _ , y .60: Backviash�Lines, P�Trap,�� Undrgind. " j ��-� '
i`0. Structural Floor SYstem r}h, � _ � . . ' ' 61: APPROVAL'TO DECK , • • - �
11. Pc,operiy Sewer Line�& Hous Connec[ion .
�� , ?i.. �� 62 Backwash &.Receptor-Fina� . . ,
12. Sewer Cap V ' �'� ' ` ,63_. Heater &�Vent-Final : - � .
.,
� !
7,3. Roof Drains „ ' . . , - _ 64: Pium6ing System � Final • ' . . _
�7,4. Rough Plumbing- z' V � �� _ � ' ° ,65: Electrical-Final '� i , .. �
= 1�5. Rou9h Electricaf� ontluit ' �' , • - . � � � � � - � ' � ' . ,
_ � , '66.' Solar System: Finai
r ,�
;y6. Rough Electric Wiring - �, .. -67r' Fencing & Access Approval ; �`, - �
77. Rough Wiring Sign ' , 68�- APP.ROVED:FOR PLASTERI�NGa s , =�
c . r �.
�78. Rough Electricaf�T 8ar Ceiling i - -� - 69. POOUSPA SYSTEMS��FINAL '" � ' �
- � � 19.� Rou h Heatin & Air Conditionin � � � � � �p � � �
9 9, 9 ,,. F E,DEPT.'REQUIREMENT
!�. . M � � tr� �c :s v1 A� iP'.�. w . . :l:
20. Rougli Fzctory Fi�epiace � y� �� y �':; °_-.�r �;APPROVQLS:,; Peimit # Y M
21. Ducts: in StructureT,. � '' •' `^ 5 � S C r-� s� "• 70. `Under°iround H�dro
r-- -n � �' �- a; C� r f' �t� . � �. 9 J
22. Ducts: Ven;tilat.in -': � . _ �` • �-,. �, --- `, - �
y, 9q�g :Kt� tr i� .,x<,71. ProduGt�iping���Gas �Oil
23. Gas Ripe��ough & Test !'75 �:*� -� _%. O��' �. 7p, Undergrok �d F,i�sfi'` � F
.,i� e..m !`...^ r;c �
�... �' •.- �. :-, � _ r �, �j c � , .v -, - ; ;m j: x ` �
24 oof-Fra�ning' u�, �7 �� �.y, '.73., Undergrnd.Stoiaqe<Tank.�Gas GOii
25. ft of. SheZ�hing Yrr.� F ��. ZI_ yG'+ ^ ���� �'7q`,'d�erhead Nydro;� , Y
��*: �r s
"�. t0 _ '):.' mJ V i�
2.!�Ba?.Ceiling (Structural) & Mono`coat �� i-< 75- r
�,. _,., n �<D Y Chemical _ ;.
27. F�ameand�Flashirig;� _ -�x z�c^ � 'ar � � � �c' � � J
76. Dry StarjdP+Pe `�, . �. n :�, e.
�+'Y 4�' 'S r
-�28. Lattiing S�Sidsng ! ��'' �.'A� `. * -- ' �,. 7� FIXED _SV-STEtO�,;FINA� :� � `
��29. Insulation t�.:s. � S � � � � 7�; FIRE PREV. F�NAL �i � i" '�
30. Drywali N,^ailing �.�' H � � t, � �` c �HEALTH,DEPT.'REQUIR�EMENT
� 31. Plasrer Bmwn_Coat r 5 i"�'. � + ' 'Y ' 79� FINAL INSPECTION 4 =
' -Y T '
r 32. Electrical�Power Me, erF4�aI ! I #"' � ;x �' 8Q� FOOD CERTIFdCATE ISSUED' rx =,
-' r r . ' O� : ' - a. t�: w �: ' •-' „
�33. Finai:Electrc:. �+,r. ,s� I � :K � �Z � � Notes: `: • = G '�r: � ' 1`"=
�. � - x �-. < - .,'e :
�34. Final.Neating�& Alr 6onditioningS � � T � J"N� � � S �' � z' S O:`� �`� ��
.n �- r. _ .'s %7 * ' i �> i }-: I E'�`: 'S �w`
` T �y
35. Final Gas�Pipe�Test{x ���' •• � I�_ �� ; � i'o :,;- �} rv f-' `_',; �,,,
z136. Hood�or GanoPY �'. � ` , �'- <. k : � � /��x : i no ' ��. _ e � S,}.
... : � m+ n .�.i-7 �r x %!i �� [*1 , o . '7C7 .,y.•
y� ;.n ' fi '_+ � � P' v� 4� i t • f - ' . . , Y .:
�31. F.-inai.Factory Fireplace x � _:r. .-• :t � y -� � x • _ .. ,
.* n. s `�-,.'
-'38. FinaPLPlurmbing �'y rN a � � � ��° =' r * C' r7 _ �
`t; H S 41
�.• a :K � •
�39. 4Vate� Ser�ce-�Final.;,: g . :: t; � � .. �_ � ' t �V S -' 1
�v [�r.-. v:''.- K�
�40. Gas Service-Final tc;. -.7 ^: r S � i: I �' � U�+ .�nl �f� �
n x ; t�, r-, rrt �: r-. . �, g ,. �t .
=41. Solar pomestic',-Fina(� 5 �� „ � � '' = � � ' .
'� x I a� (*' .-, c� r. x 5
�42, Backflow�f'reventer.r�� tv :i . ""' �+ '>F � *'� *-'
�• rr m rr��.a x�-+ >k :*1 :�7U`'� � -
� T ' ^�[ � m l• '
. 43. B,ackflow Irriga ion7r y�-.` "• ^ '� s, � -e' Cl .
�.
' 94: Landscape�irrigation:System �`T'�= Q �' � - h C"� ' f`` ��' �'r� � ~ �' -
-, r - �:-: i,: �c: r. � . <^. � c� x � :5 i-�
� 45.� Sound Attenuatio � � .'�� � �' F' � �� � �' � v��� u.�� �
;c m r} � E- � � �=G F C. �
� 46. Handicap Regulations r' C .� � x } . "' -- .-y =1 � -y". .
< ;� � � tcv0- i:7 �
. 47.� FINA�L S7RUCTURE & BUILOWG 2� l6 !' ,��,y ' �" i �+ _ �,
A, , t ,.,
�48.F1NALPI.ANN�NGt i�.i- �sv C//���+ ' � '� . c'
1 A � '
� 49. Electr;c Release to Edison � w % �} `' �' �' " .
�� .:. + i . �: ti7 � : x'
� 50. Gas Release to•Southern Californ'taGas Co �• '��'�'� �'"� � ^ =� n �` � •
Y ��c e- i < S .-i r. r.
_51.'CERTIFICATEOFOCCUPANCY - ":;" {� -,� '� ` r "
�/ �-�
No. � Date � �+'
' , c, , - Applicant to till in all spaces except lhose within heavy bortlei lines�antl sign all appropriate Geclarations.. " - , _� _ � .-_ �. .
PERMIT NO. � TRACT NO. , LOT NO �' ' * '� � � �
, CITvoF COSTa MEsn CONSTRUCTION PERMIT - ,�g , • uNiT=No: � _ • ; ' %437 7.-/25/85 ' I ue'u0 TL�
. Project Address 9S3 DclYllld - i ' - i � - , , ' i . � ��� � � � t"
TYPE OF CONSTRUCTION NEW � �AOD . ACYERATION" '�REPAIR � r� M1
Applicant;s Mailing Address 5413 E'. lia Palrtia-Anaheim 92807 . . ' �� � � � � � � � - `
U ❑ CONVERSION � � DEMOLISH '❑ OTH�R ' ' ` - � ' - '
Owner's Name Mr. & Mrs. Daniel. Gott pho�e 556-0976 A•P•.# . • � � ' Zone y
• � DESCFIPTION OF WORK/USE OF BLOG.'S1T1Q e ami y resi 21"1C2 �
Address 953 Ddh113—COSt.d MeSd�. 92626 � , � � � -. ' S �vlain euilding:: . Acce'ssory Bui�ding: - �
Arch/Eng. License No. TYPE OF PERMIT ' . GRAoiNG ❑ FOUNDATION ❑ STaucTURA� - - T Front ' � _ � � � �_: - ' p
Add�255 ' "' � � � ' ❑ TENANT � ELECTRICAC O PLVMBING � MECHANICAL .' B _ R¢af � ' � ' ' , ' � � � , �„ � , N
Contractor's Name �PrO H2cltlriCJ. & AlY' � Phone •779-68h8 ' �'oTHER ' . � ' . . i ' - " � /> y . _ I
P,ROJECT DESCRIPTION� 5Q. FT. ��1470 � ` pCCUaANCV C Right . - ' i' N
Addresslmailing) 5413"E. La Palma-Anaheim 92807 . � , K- - - - c
r , CONSTRUCTIONTVPE ' � VALUATION$- �g� Left ' 'i �� R
.' , � - �i 35 ZS '
� -., City License,No. ` ' I ' ' � ' ZONE � ' • GRADING CU. VDS. ACRES 1 � '
._...."... . - . . _ .,-- . Pln - Ref. # Parkin . 1 '.
� LICENSED CONTRACTOR DECLARATION � ' 9� q R¢q./P�ovid¢d 'E• �
. 1 hereby affirrti that I� am licensetl untler provisions ot Charter 9(commencin9 Remarks: � � . . ' Pldnniny NOt¢5: ' • - - M •
� WIIh 5¢CLIOl1 ]000)'of� DiviSion 3' O( Lh2 BUSIIIQ55 dlld PfOiE5510O5 COtlC� dflG � ', �
(� my Imense is m full force 7qtl Gf,(e�a. 469637 . . � � �� � T �
��� License.y{as � l. LU �icense N � � S
1 U Date �� 1 Signature - � � PLUMBING . _ FEES _ ? _ . . . - _ . ' •� . t
WORKERS' COMPENSATION DECW RATION Bar Sirik � . Showers ! � � � � � '
I neretiy aftirm tnat I nave a certif�cate of consent to seli-insure or a certiimate . ELECTRICAL . i i � � FEES . '�
of Workers' Compensation InsurSnce, or.a certifietl copy thereof (Sectlon gackflow Preventer �• .ServireSink •
Automatic Washer � Transformer ❑ 15,50 KW
� "3800. Lab. C:) ' " � . . . ' .4 - .
Po�icv t�o. ' S4-06392 comvan Homeland �Ins. 9 SewerCa ' . ❑ 50,+KW
Y Backflow Irri ation p ' Construction Pole Sub.
❑ Certifietl copy is hereby�furnishetl. ., ' � � . . , . • ' +
�CerYry1`i o y s tiletl witn the city Builtli�ny Division. . Bathtubs Sewer Connection` % Cooking Unit . Meter ❑up to'700 amps�-
Date /���P2S�� AOPlicantPrO"tledtlR�J � a�li� ' - . �. � , . 4` ' � � � '
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION � Cld�ifi¢�5 1' SOIa� Col12tt0�s � ` Di5hwd5he� , M¢[¢/ ❑OVC� 100 ampTs_
(Thissection neetl no[ be completetl if tite permit Is for one huntlretl ($100) o� � � ' � �
less).. , . ' Dishwasher ! � SolarPiping' � i ' ��,Dryers ❑Gas��Electric �,Su6Paneb � � .
I I certity that in the perTormance of the work fo� which tM1is Derm�t is issuetl, I , � - �
snalbnot employ any person in any manner so as-to become subject to the Drinking Fountains , ' SolarTank - • ��� Fan� � ' ' Motors �0-1 HP$]1'f.-8 . 2 ��
, Worken' Compensa[ion LawS ot Cali(omia: ' �� /
. �ate ' � ' Signature ' - � Floor Drains - Swimming Pool w/Spa - �F.A.U. '
'NOTICE: If, after making thi5 tletlara[ion, you shoultl become subject to the � � InG 5013� �9-15 HP 016-15+
_ Workers"Compen5ation• provision5 of the Labor� Cotle, you_must fo�thwlth� FIOO�SiOkS.. -.. . .. U�in21 -- •'�-� - - - ' �Fixtu/¢5 � � ` ' �" " '" '
' comply with- such Orovisions or' this permit sh511 be tleemetl revoketl. • � � Microwave �'i'
' CONSTRUCTION LENDING AGENCV�' ' ' � ' ' (�id5 S¢rvicE' « Out12t5 Wdt¢� CIo52t � ' Device Bozes ' �
1 nerety aifirm that there is a'wnstruction lentlin9 agency tor the�perPormance ' �Po�e�Light �
of tM1e work for whlch this pe�mll is �issuetl (Section 3097 Civ. CJ , Int2�ce t0�5 � � -
� p ��r ' WaterHeater Outlets •Range i - '
Lentler'S Name'" " ' �
Lentler'sAtltlress. � �'� ` � ' � KitchemSink� _ � � � WaterService � - ` - Switches � Sign' '
OWNER BUILDER DECCARATION � � � +'
� i I hereby affirm thal I'am exempt trom the Contractor's License Law tor th2 LavatOli¢5 � '- ' � AutO-Wash. ' Galba e Di5 0521
�, followinq reason (Sec[ion �031.5 Business antl Professional Code: Any ciry or ' 9 _ P ', Standing Sections �
��� r'%� ' munty wM1ich requires a permit to construct, alter, improve, tlemolish or repair � p—Trap •-- � � 'Laundr T�a 5 ' '
; . . Y V - Generator DO-5 KW 05-15 KW �
- � any st�ucture�, prio� to its issuance, also reqW�es the'applicant fo� such permit ' T�Bsh COmp2ct0f
.to.file a'siqnetl statement [hat he/sne is IicenSetl pursuant to tbe provisions of � � Roof Drains . �� ' - �
roe Contracior'rLic¢nse Law.(Chapter 9(mmmencing with'Section 7000) of - . �
� Divisian�3 of tfie'Business antl Pro/esvons Cotle)'or that he/she is exempt - , .
� theref�om antl the basis forthe allegetl exemp[ion. Any �violation-ot Section . ' ' _ � - . ' , . •
- ; ]031.5 by'ahy_applicant .Tor a permiY subjects the applicant 4o a, civil ` " � `' ' � ° � � " �'
�enalty of not more [han five huntlretl tlollars ($500). , � _ � ' ' '
I, as owner of Ihe property or my employees.with wages as theic Sole �R¢in5p¢C[iOn Fee '�$15' ISsu¢ Pe¢ '' $ 3 '
'�compensation, will tlo the work, antl the:structure is not intentletl or otferetl ' � �Reinspection Fae $15 'Issue'Fee 1 ;$ 3
�. i�for sale�(Section ��044, eusiness and,Professional Cotle: The Gontractor's' " -- ' MECHANICAL ' FEES� �
' License Law tloes not apply to an owner ot a property who build5 or improves � ,
� thereon,.antl,who�tloes such work nimselt/herselt or through hiz or her own - ., DEVELOPMENT SERVICES REQUIHEMENTS: •
' employees, plovitlCtl that such improvements are not intentletl o� ofteretl for ' . BOil2� ' " HOOd OI � Typ21 �❑ , '
, sale. If, however, tne builtling or improvement is soltl within one year of mm- � . ', Y-^ � .Canopy : Type II ❑ Zo�ing Approved By Date
. oletion„fhe owner will have the burtlen ot provingjhe/she tlitl not builtl or im- , DuCt -'Under Ground- � � guilding Approved'By Date ' '
� ' plove tOr tM1e pulpOSe Ot sale). ,;� , „-- ` . . � , , -
.❑ I; as owner of the property, am exclusiveiy contracting with.licensetl con- 1 Duct=Structural .� ' Refrigeration System � � � Application Issued 6y �� Date 2�
� Iractors to conSV uCt the projec[ (Section �044, Busine55 antl Professions Cotle: �. ' - ' T—
' The Contractor's license Law tices noi apply to an owne� of pmperty who Duct - Ventilating � �0-10Q000 BTU ❑100,000 BTU �; 4 �� � ' � SUMMARV OF FEES - '' '
• builtls or improvez thereon, antl who contrac[5 for such projects with a•con- - - � - � �' - • � .
:
, tracto.(s -Ocense pursuant to me'Contractor's Licenre �aw). I am aware that y ' Exhaust System ❑'Multiple ❑ System Repair/Alteretion � ' - ' BUILDWG PERMIT '$ - SMIP� ' �$ j
. proot o� tneir Worker's Compensation insurance shoultl be provitletl to me. - PLAN CHECK $ PERMIT • �
. L7 I am eaempt untler Section � B. & P. C. (or this reason Firepl/FacL Blt. ICBO # Fire Dampers � �' pLUMBING $ ' ISSUANCE �$'
'� � Date• Owner , Heating SYstem & Ducting , Registers '
' PLANCHECK 25% $ ENERGVP.C.'-�$
, I hereby�.certity that I'have-reaa this:application and state��thai the above •�0-100,000�BTU 0100,OOOBT - . -� �-, � ' S.00 � GRADING �$.
informatlon is wrrecL I agree to wmply with all city ana county ortlinances i Q �� ELEC7RICAL $
antl state laws relatin builtling construction, antl hereby autnorize repre- ' MICROFILM :$�
sentatives of Ihis 'c' y: o enter upon ne above-mentioneG properry for , � , ' ''"" ' � � ' PLAN CHECK 50% $ ,
inspection purpos¢s • 1
. Siqnature � � Date7/19/85' , . , , . �; MECHANICAL '$ LZ.00 TOTALFEE $� 16.00
Orivers' License or «-� � — — Reinspection Fae $15 Issue Fee • $ 3 PCAN CHECK 25% $ . .
, CMF 0865-46, rev.10/84 White - Builtling; Canary - APPlicant; Pink - Accounting; Goltlenrotl - Assessor � . . � ,
. ,l ,CONSTRUCTION AND PLANNING p ...� �. }� � - . . � �. . POUL & S°A -: � � �- . ' ^ ._ �i
� a -s Date+ - � Inspector � ' � �' �� Date'� � Inspectar �
� ��"APPROVALS � Permit#, ' ' _ R "_APPROVALS :�'Permrtw#: - - ,
� ,�7: Temporary Electrical Service or Pole; { , - " � 52.:Pool�& Equipm'ent-L•ocation' '. �� ' ,
,_
:; a. ' .. , . ,
� r2. �Soil Pipe-Undrgrnd. ' -. � " � �? . : � �'' 53. Steel�ReinforcemenY� , - _ -'
' 1 z3. �Electrical Conduit Utility'-U�drgmd. :, - W ` ` ; � ?� � �' � 54.:Forms'- " �,- d�,-� " ., , �
' . �4.�Electrical Conduit�Undrgrnd, _ ` � �. � _ � � _"� 55. Elecfrical.Bonding^�. � ��'�� � - � `� •
� •
:>;•,
� ,M5. Steel �Reinforcement, , r ', c : d , ' = n . - �: s � 56:-�Rough Plumbing & Pressure Tesi � _ � - - -
��6..ElectricalUFERGrnd.�. � � ; ���= � ' � _57:�APPROVAl�TO.COVER:GUNITE � -;r
.. � i , _.�x .; ' . - .'-. - .I..
_ i �,;7. Footings • .-� � � _ ; r � `� 58. ,Electrical;Conduit=Undrgrnd,�: � . -. �
�'� `8. Foundation' . � ,�' � ;. ' � _ 59. `Gas�Pipe, O �Und�gmd.,`.Test� • � - '
' 9. Water,�Pipe-Undrgrnd�. J � - � �- ' r:•60..Backwasfi Lines,P-Trap, �'Undrgmd,�' - � - � '�
, � ,
' �10. Structural Floor SYstem ' � � � `- � , 6Y: APPROVAL'TO DECK�- - �
'a 1.7. Property Sewer. Line & House Conriection � � 62, Backwash'& Receptor;Final - . . .
' �t-2. Sewer Cap � � '. - • " . ' - , = .-
.� _ -63: Heater_&Yent-Final . . . . .i
13. Roof Drains � � � � ` - . s'� 64�. Plumbing SYsiem - Final � -
; '� 14. Rough Plumbing �i' � � '65�. �Electrical-Final � ' ' � ti � = �� � � '
��15':•Rough�Electrical-Conduit�- �` .� � �66.�SolarSystem-Final`� � � -�" -- ' -
' . �16. �Rough Electric Wiring. � i�, - ' ` �;` � � �67. �Fencing & Access Approyal � � � - � �• �� � -
: '' 17..,Rough Wiring,Sign'' `- . - , � � 68: APPROVED FOR PLA$TERI,NG •
,
' 18a Rough'Electrical-T Bar Ceiling ° � � . � . , - � ,69. POOL/SPA SYSTEMS FINAL � � � �
"' 19;-,Rough�Heating &�Air Conditioning � �' � � � � FIRE DEPT.•REQUIREMENT � ' � " �
�. . , � . , � , ; • . .
20:,•Rough,Factory Fireplace ' ' :� � ' APPROVALS � Pe�rmit # � � � ' ' '
21 Ducts,,in Struaure , � � ' � . �70.� Underground Hydro � ` ' �
`� 22. �Ducfs;.Ventilating ' � � ! � 71: Product Piping O Gas. � 0 Oil � ' � ` � �
� �23. �Gas Pipe-Rough & Test ` : � �i-, . ' ' , 72,4 Underground F�lush ' _ '
, ._
' 24.�Roof�Framing� � � � � �� , . ' 73: Undergrnd,StorageTank OGas'�"OOiI � � '
r �� 25. Roof Sheathing ; � „ � ;, , � 74, Overhead Hydro � • � .
�-26. T=Ba`r Ceiling (Structural) & Monocoat � . 75: Dry C6emical � � , - . ,
. �,27. �Frame and Flashing. �; ' �� � � � �76.. Dry Standpipe � � � - �, r..
�• 28. L'athing &-Siding ` ' � . 77. FIXED SYSTEM FINAL �
, 29. llnsulation'- �� � ^ - � . � � . �78. FIRE PREV. FINA�L ' ' ' �
� � � ' � HEALTH DEPT.REQUIREMENT ' �
30.'Drywall Nailirig ,' ' i �
. t�31. Plaster�Brown Coat � .{ . � ' �79.� FINAL INSPECTION �� ,�
y ' �32. Electriral�Power Meter-Final . � � • � � 80. FOOD CERTIFICATE ISSUED �
R ' ' . , � � � � .
� • 33 Final Electric � � t � , ' ' Notes: � .
, _ 34. Fin'al:Heating & Air'Conditioning; �� ��� ;( �D v � ,, .
35. Final-Gas�Pipe-Test - ' ��� � � - � � � � � � . � . " '- . . , ,
36. Hood or'CanopY, . , . � 4 . . ' � � � - 1 ' . � '" � � -
� r , . .
37. Final F,actory Fireplace� � . � � � � ^ - . � � . � -� , - �
i
, . . � � � . . . ------- � - . , .
38. Final Plumbirig � � � , �� ' , � � ' • - � •
� ,
39. Water Ser'vice-Final' y � ( ! ', � � ' ' - �
i
40. Gas Seivice-Final • � - � � , ' �
41. Solar pomesticFinal . ', � . ( : _ �, _ _. , - _ _ � . ' � � � ,
42. Backflow �Preventer � � � � , i � • , � . � + - .
_� . .
'43. Backflow Irrigation � �� � . ' � , , .. � � �, . , -
: , . = '� , i - -
44. .Landscape Irrigation SYstem � ; � � , ' ' � -
' 45. Sound' Attenuation' ; � , ' � � , ' ' � ' r � , � � ' -
� i � i -1'ri ' i i_ �t
46. Handicap�Regulations ' � � � � � � • ' - �- � _
, �
� 47. FINAL STRUCT,URE & BUIIDINGi, � � ' , � � � � � � � - � . � � , -
i i �
48. Special Requirements Complefed' � � � � : � ; � � � ' ' - '
� i ,
� . 49. Electrie Release to Edison { _ " � � �� '� ' �- -'' ' � . ' ' `" -" ` � �
i � ._...� `. _ .- .f. _ � .. ._�- - � ' 'a
� `
50. Gei Release to Southerri California Gas�Cn - . + i 4 i � � � � � � � � � , , �
, � � � i � :x
51. CERTIFICATE OF OCCUPANCY. � n " _ _. .__- �,�_: ' : �_._I y i _ '_ _ __.; _ �._; . . ;� i�� • � . •
INo . "� . `'= -" Date' � � , .. ' .�_..i_.... ' ..? . � '_�_ � _ ' .' . - �.
. . - - - .�_ . . .
9
ry� _ .. •
ry
� MF '` CITY OF COSTA MESA
� BUILDING DIVISION
} � DEVELOPMENT SERVICES DEPARTMENT
r "
o .�A�,a,t,':,., PERMIT �
�qo.°"°'s° `� . .. .
(714)754-5273 • Fax(714)754-4856
PLUMBING PERMIT
dob Address: 953 DAHLIA AV
Suite No
Vicinity: , .
Parcel Nunmber: 47218344
Applieant: RON
Address: W/ NOCK PLUMBING
Owner:
tr'acto���N
'dr
dress:�.,,/71
�-�� c�
��` ��lr
�
j (t�
hlEng:l )r,c
��"".� %�1.:
I.I ��i�i
ISSUE FEE� A��� i $22.00
Backflow iriigation `/ $0'.00
BackFlaw Prev`ente`r $0.00
Bathtub ��� ��$0.00
ClariferSystem��`l i� $0.00
Connect pce,Soda,etc) $0:00
Dental Unils ���� �$0;00
Dishwasher �� $8.75
Drein, Floor �� $0.00,
Drain, Rainwater �$0.00
Drein, Roof �$0.00
Drinking Fountain � $0:00
Expansion Tank $0.00
Gas Earthquake Valve $0.00
Gas (i-4 outlets) $0.00
Gas (Over 4 outlets) $0.00
Gas Repipe $0.00
Gas Service '� $0.00
Interceptors (Grease, Oil) $0.00
Interceptors (Sand Auto ) $0.00
���
�;,Js: � a'; PERMIT NUMBER; .,. ;
, _ ... P98-00825 r/
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 11/09/1998
Issued: 17/09/1998
i� /`��j Phone: 714-895-1246�`;��.,��
/'�`� , i ?�P' f I ! '���.
�� �� ! �2� � I� � �
JAMES'TR'='" �� ` �'� �� �
�"�J,%,! J:=�� "� ���-� �� �
Phone: �`� � \
i� Zip: 92626 �/`�
��
ST
'�;!t���l� i�it' ��r���ZiPt
License:
��_.. ._.._n�
� �.1�''-���SGOPE
DISHWASHER'� �-��
i
f FEE S
Qn
� Laundry Tub / Was
0 k Landscape Irrigati�
0 P-Trap ��t �(j �
�0 � Pressure,Re`gulato
l, ���� ��'4�°�����
//'1 \�Sewei;CapJo�Demo�i'"�"
r ��9ewerrConnect%����v�"
/ "O�J Q
��0 �'� Sewer.P.iivateiine�''��}'
0 v� CShower
Sink; barr� �-
�������ti� ,.
�0�� LSink; commeiciall�� ( �1
0� ..,_ ink, Floo�-� '
o.� _ S J � i\\ r-
0
0
0
0
0
Spa
Spa
$0.00 0
$0.00 0
$0.00 0
30.00, 0
$0.00 0
\�
0
Urinal� ti'�;. �t $0.00
:Vapuum Brkr Bkflow(1;4)��$0.00
;Vacuum�Brkr BkFlow(5+) $0.00
Wash.Basin� /� $Q00
Wash�Basin�Set� $0.00
�Waste and VentSystem $0.00
.N/ater Closet (T�oileQ $0.00
,WaterHeater'/vent $0.00
Wate�Piping (Inst or Rep.) $0.00
�WaferRe-pipe $0.00
N/ater Service $0.00
Water Softener $0.00
OTHER $0.00
VIOLATION $0.00
PLAN CHECK $0.00
REINSPECTION $0.00
� � TOTAL CALCULATED FEES: $30.75
COMMENTS / SPECIAL CONDITIONS
f
�
an
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 ot 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 inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL:� (714) 754-5626
WORKERS' COMPENSA710N D�CLARATION:
I hereby aRrm untler penalry of pbrjury one of the tollowing dadarations:
❑ I have end will maintaln a cBtliticate oi consent to 5eN-Insure tor workers' compensation, as provided tor by section 3700 oi the Labor Code, tor ihe parlormance oi ihe
work far which this permit is issued.
[]/I heve and will maintain workers compensetion insurance, as required by sedion 3700 of ihe Lebor Code, for Ihe pertortnance of the work tor which ihis pertnit is issued.
My workers' compensation Insurance cerner and policy number are: � �(�� q j `p�
Cartier: . ��� ���� PolicyNumber. ��'�"��/�Y'�I��'
(This section need not be completetl il the permit is valued af one hundred dollers ($100) or less.)
❑ I certity ihet in the peAormance of ihe work tor which this permit is issued, I shall not emD�oy any person in any manner so as to become subjact to the workers'
compensation laws ot Calitarnie, and agree that If I should become suhject to the workers' compensetion provisions of Section 3700 of ihe Labor Code, I shall fonhwlth
comply with these provision /� c�
Applicant Signeture: ��— -�� / Dete: �� � 2- — /d
WARNING: FAILURE TO SECIIPE WOqK RS' COMPENSATION COVERAGE IS D SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENFLTIES AND CIVIL FWE$ UP TO PYE MUNORED
THOUSAND DOLLARE ($100,OW), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIOEO FOR IN SECTION 3]W OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES.
i LICENSED CONTRACTORS DECLARATION:
� I hereby aftirm ihat I em licensed under provisions of Chapiec.9 (commencing with Section 7000) of Division 3 of the Business�nbProtessiurs Code, and my Ilcense is in full
force end eHed. Lic. # `i �i 7 � Class a 7��
ContractorsSignature: �5\ � Date: �J-7�--�N
�
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirtn that ihere is � construction lending agency for Ihe DeAormance of the work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lender'S Name: Lender'S Address:
SignaNre: Date:
OWNER-BUILDER DECLARATIONS:
I hereby attirm ihat under penalry of per�ury ihat I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business end Protessions
Cotle: Any ciry or counry which requires a pertnit to consiruct, alter, improve, demolish, or repeir any sWcture, prior to its issuance, also requires the applicant for such permit
to tila e signed statement that he or she is licensetl pursuem to the provisions of ihe Gonirecbrs License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business and Protessions Code) or thet he or s�e is exempt theretrom and Ihe basis tor the alleged exemption. Any violetion ot Section 7031.5 by any epplicant fore permit
subjecis the epplicant to a civ�l penalry of not more than five hundred dollars ($500).):
❑ I, es owner oi the propeny, or my employees with wages as their sole compensation, WILL DO 7HE WORK, antl the structura is not intended or o8ered for sale (Sec.
7044, Business and Professions Code: The Contractors License Lew does not apP�Y �o an owner of property who builds or improves Ihereon, and who dces such work
himself or herselt or Ihrough his or har own employees, provided that such Improvements are not intended or otlered for sale. If, �owever, the 6uilding or Improvemen� is
soltl within one year of completion, ihe owner�bullder will have the burden ot proving Ihat he or s�e tlitl not builtl or improve for purpose of sale.).
❑ I, as owner of �he property, am EXCLUSIVELY CONTRAC7ING WI7H LICENSED CONTRAC70RS to construct Ihe project (Sec. 7044, Business and Professions
Code: The contractors License Lew does nol apply to an owner oi property who builds or Improves ihereon, antl who conlrects tor such project with a contracmr(s)
license pursuant to �he Coniractors License Laws.).
❑ I em ezempt under sec. Business and Professions Code for this reason:
Signawra: Date:
Owner ID veritied 6y dnver's license. ❑ Yes ❑ No Driver's License No. Expires:
Venfication of Ownership by (rype ot document, i.e. - pmperry ta�c bill or deed):
DIVISION OF INDUSTRIAL SAFp7Y PERMR CERTIFICA710N:
❑ I hereby certily Iha� no excevation five (5) or more feet in depth into which a parson Is required to descend, wlll be mede In cronnection with work authorizetl by t�is
permit, entl thet no building structure, scaflolding, talsework, or demolition or tlismantling ihereot, will be more ihen thirry-six (36) feet �igh. (Chap. 32, Grp 2, An 2, Sec.
341, Title 8, Celifomla Administrative Code).
❑ As owner-builder, I will not 4mploy anyone to do work which would require a permit from the Division of Industrial Satery, as noted above, unless such person has a
permit to tlo such work from the division. �
Signature:
Division of Indusirial Safery Permit Number:
Date:
ARDOUS MATERIALS ANO EMISSIONS CERTIFICATION:
Will the applicant or present or fuNre building occupant need to fila and certity a Business Plan for emergency response to reiease or ihreetened release ot a hazartlous
matenal7 ❑ Yes ❑ No
(Section 25505 of ihe Calitornia Healt� entl Selery Cotle requires, wiM soma ezceptions, ihet a Business Plen be filed with the Costa Mesa Fire Depatlment by every
business which has at any ohe time during a reported year a quantity of hazartlous matenals equel to or greater ihan e weight oi 500 pountls, or e volume of 55 gallons,
or 200 cubic teet of wmpressed gas at stendaM lemperature end pressure).
.............................................................................................................................................................................................................. ........................................................
Does or will the epplicant or present or future building occupant need to tile a registration torm tor acutely hezardous meterials7 ❑ Yes ❑ No
(Section 25533 ot ihe Califomia Health and Safery Code, with soma exceptions, requires registretion with ihe Costa Mesa Fire Depenment by eech business which at eny
one time has on hend e quentiN o� ecmely hazartlous metariels equel to or greater than e weight of 500 pounds, or a volume ot 55 gallons, or 200 cubic teet ol
es or will the applicant or preseN or �
Yes ❑ No
�ction 25534 ot ihe Califomia Healih
Oertmant ot en RMPP by busineues
occupant neetl [o propare an
Mesa Fire Depariment may require ihe preperatioq cenifiwtion and tiling with the Fire
3rdous materials with ihe Fire Deoariment.
It an RMPP is presently required, has Section 25534 ot the California Health antl Safery Cotle been tuliy compned wrt�7 LI Yes LJ N
...........................................................................................................................................................................................................................
Does or will ihe applicant or present or tuwre builtling occupant require for tha work which is the subject ot this e plication agertnit tor suc
from the Sou�h Coest Air Ougliry Management Distnct or irom any other eir polWtion contml distnct or agency? � Yes ❑ No
(Section 658502 of ihe Celifomia Government Cotle requires that the requested informetion 6e fumished on epplications tor non-resideniial
.................................................................................................................................................................................................... ...................
Will any part of the taciliry to be constructed untler this permit be within 1000 feet from the outer boundaries of a school? ❑ Ves ❑ P
pf yes", the taciliy must megt Ihe requirement of Sections 25534 and 42303 ot Ihe Calitornie Health end Satery Cotle).
...........................................................................................................................................................................................................................
It a permit irom Ihe South Coast Air �ualiry Manegement District or other air polWtlon conirol tlisMct or agency is requiretl tor the woi
aoolication. have all ot the disclosures orescnbetl bv Califomia Heelth and Safery Cotle Section 42303 been made7 ❑ Ves ❑ No
or
e Qt yes", attech certitiwte of complience irom ihe aDDropriete eir pollu�ion contwl oHicer).
CERTIFICATE OF COMPLIqNCE: I certily thet untler penalry of perjury ihe information given above is correct I agree to compty with all state laws and ciry ortlinences
regartling Hazerdous Materi�ls and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE qND AUTMORIZATON OF ENTRY: I certity under penalty of perjury that I have reatl ihis application entl state that ihe information given is
correct. I egree �o comply with all state laws antl ciry ordinances relating to building constmction, and euthorize representaiives ot ihe Ciry oi Costa Mesa to enter upon ihe
a6ove-describad property tor inspection purposes. I agree not to occupy or allow occupancy oi any building authorized by �his permit until final inspection.
� I S' atur Of Legal Owner s) Date
//'-i L-�
AnNOr Authodzed Applicar - � Date
COUE 1. INSVECTIONTYiE
1616 Fixed Systam Final Flra prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Final Demolition
2466<6
PAg U�ElS
yflpE� INSFECTIONTYPE
206 Finel Mechanicel
20B Finel Plum6ing
210 Final Elecincel
212 Final Fire Prevention
220 Final Plenning Approvel
222 FinalSite
250 Final Building/Occupancy
QAiE It�lS
`_ .
May 2, 1973
LARWCIN of SOUTN.ERN CA7,IF.,INC:
16%J5 VE?ltU*'� $�.VCl. . .
Encino, Cali"ornia 91310
_ , �18 9�0
Attention� Nfr. Dnn Downs ��,,'� � jij�i
Subj�ct� Greenh�co �outh Coast '� ��,pyi��3 ��
Trac �718 c;; �r.�"�•ir� r
i �. Cal ; f, ^ j��L ' L o;
ot 7 a Plan 201 ;� �, j}'�'r°��S �;
��
���9�s'`z�z � ��,z�ti� .
Gentiemen,
On Mondayv, .1pri1 30, 19�3, P/lr. Tom U''anahee and a crew
from ^;+.1.-Ri�.sa ro^�+ru�+i.on C:orn�-?.ti-en PY.T?O:�d on^
't?T1�nP. _^ tna ararp !n`' cU�'pC� !"�^'.f,fj n r.�t.�,.
- P_._. ; .. �__., h^L3:., L:i:,
�Pnlin.. �.r�� -.�,..��cit'? 7+ _.-a..�.,_ . :�' =11 � Ti�ir.par� pn �h�,
i^�.US� th? I.n��t �,.c�e�b].e to +,he qr_c:vnants. - -
r. nahnv�c ro. i o + ��
bi ?7�.._,.._ ,... aart ,.o m stat�d �hat tne +„snd�n :�:?s
r �an. ;,,.,�� � :
+�.IY:dP. .i rCS!?lt: ?i' -F1hp Zlii'i:? VJaS �^� TY''t�. }?7�'i'O^�;.�'.f
ZpSL�n..^,;:.':'." fiGT•i;Cl�? i�i.i`. C'F .^.�:^>41 r�!'s3:i.. !'1p`._n, Vgrl.f'1EC.�
tr1.� c,a,mo: TIli.S 1.S 51.1��fiClpn?;�.Y :"!:'�'_�^.2"t1VP. t}l-_^-.'t i:PC''
tP1l!��?^S :]3V2 bn�r iA?�.�'.Qro;' i,� �rCr,�•;:1Y:C.@ ':1�}: P�?..71
rgClll�"P_t�icnt.c anri ;Ni l l c�+: :_ , a i- : y.. '�_.
,_ '._" .,._. . __� .:.� �f:8i:ei'tlC:. .�i�e� pY—
.^.$YISi�'9 SO:l. •••��:=...s� ..3. ' •
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UoV?�trU� •y y'OU'"///S � . .
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Pgl.11. G. J2C0't� ��,'�':
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16208 E. ARROW NWY.
. 1RiN!l�iDALE, CALlF, 9170&
_. .. {213) 9SZ-4431 "
LARWIN, INCORPORATED
16255.Ventura Blvd.
Encino. California 91316
Attention: Mr.`Don Downs
Subject� Greenbrook South Coast
Tract 'J�18
Costa Mesa, Calif.
I,ot 57, Plan 201
Gentlemen.
April 12� 1973
On January 29. 19%3 Lordel Manufacturing Company was
notified that the slab foundation on th= above referenced
lot ezhibited several cracks. At the time, as employees
of Lordel,-we offered to assist in attempting to deter-
mine the cause.
As z result of investigations on January.30 and February
1 it was noted that the cracks were random in nature and
confined to the iivine �reas of the slab. The,y er.hibited
no discernable differential.disnlacement and, upon c�.ose
er.amination, anoeared to have been in existence nrior to
finishing of the concrete. In additicr., there ao�eared
to be a distir.ct differenca in concrete oualitv between
that olaced in the living areas and that in tne gzrage.
Since then we learned that tests of concrete cores
taken approximately four and a half montns after place-
ment reveal?d that the �arage slab cor.crete is signifi-
n7n}l �r airne..: n... v.. .bl.n.4 ii.� t:__ �� .,"" �"'�. .i�
' � � � � .. ..i.ur i.. v . . aiG ui6aJ VUb WIC
12tter does exceed F'� as speci£ied in the pians.
Stressin� inspection records indic�te that nost-tensioning
of tha tendons was oerformed zoout October 2. 19?2 and
that wnen insoected October 5, all were �tressed in
accordance with p'ans and specifications.
Thankyou for the opportunity to be of continued service.
Very Tru1y Yoursq
SHA�'--& �COMPANY
/�;� ��-
Wk,� Shaw
cc� Jacot, Lordel
.
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� h� DAViD R. D�i���G F� ASSOC. Q ENGINEERS
c
664 MONTEREY PA55 ROAD • P.O. BOX 804 •'NONTEREY PARK, CALIFOftN10. 91734 • 12131 2B3•7946
J.N. 1302
, February 19, 1973
Larwin Southern California
16255 Ventura Boulevard
fincino, California 91316
Attention: f1r. Jerry Wahlstrom
Subject: ConcYete Floor Slab - D�•�elling at 953 Dahlia
Avenue, Lot 57, Tract 7718, Costa i�;esa, Calif
Gentlemen:'
On February 12, 1973 five, 4 inch diameter cores were obtained
irom.tne flo.or'slrb �aithin the subject dcoelling in orc?er to attempt
to determine the ca�:se of the .e::tensive cracY.iny ii1 the slab. The
approtiimate locations e:here these cores �aer.e,taken along �aith a
number assigned to each are sho�:r. on the acco;�ipa?zyina s?:eLcn
(Plate A) . All of tiie cores �•:iin the exr.eptio.^. of ,Core clo. 5 o;ere
drrLQ"'1T^�i_nl l> ' S i tinh =.c i.n 1,-h1C::31ncc (`prr� T'n, S --v,��nr =�nrl �?�.O�i'•'
4 111CR�_'S 1P L}:1C}_]-'�eG. ..• . ' "
Cores l, 3, 4, and 5�,�ere surfar_ed and compression`tests were
performed on each core.. The results of these tests are as folloi•;s:
- Corrected H/D
Core No. Compressi.on (psi)
1 3,3G7
3 3,300
4 9,?6G
5 3,380
Core No. 2�,aas taken directly oaer a cracl: in tiie slab, therefore,
a comi�r.essi.on test- �:�as not nerfo.-;r�ed on i:}iis co.r.e. The crac}: �•�ithin
this core. caas iound to b� coi;;:ir.uous irom i:on to bottom of: the slaa.
IvTo definite conclusions as to th� cause of crackitiq ceuld be drac:n
fT'Oiil c1 Cc,IC'rSll�. 17?=;��-'Ci,1017 Of L�:15 COTC }JV Pc^cT�OY:ilc:�. fT'Oi?l �}?].i OSi1CC,'
or by personnei oi the Portlanc Cement Assoc_a�ion ::�I;o �:erc asked
to inspect this core. Howaver, none of tlie coarse "aggregate o:as
f:ractured cvi�ich �•:ould indicaLe that che crac}:ing occurre3 whi].e the
concrei:e i:�as still in a ple.s'tic sta�.e.
S��L MECHANICS • FOUNCiATION ENGIf�[[RING
-. _ , .. . �. .. - � . . . . . _.
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. . Lazwin Southern California
Page 2 .
February 19, 1973
.,-. y
� .. � � I .
� � . ''
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�
, ti ., :.
. -.-.--.._ . -- - - -- � " �__
J.N. 1302
Only a fe�a very small cracks ��:�re noted �•lithin the garagc slab
and the compressive s�rength of the core tal:en there �oa� appror.i- •
mately 25 percent hic,her thar. tliaz of the other cores tested.'
In summary, while ar.alysis oi the core samples did not produce a
definite ans�•rer as to the cause of the er.tensive crac};inc�r of. the
slab, it is nossibJ_e that the crec}:s may have occurred due to
irnproper curinq. T77e lower. str.eilqth of tl�e cores taken ��ithin the
living portion that: that of �Le core tancn in the garaq� slal� may
Ue ihc result oi a hi.q??�r rrater-ccment rati_o b�ing utiliLed in
concrete in thc ].iving portion of i�he d��ellinq. Sf a hiqh �vater-
ccment �::as uti7.ized, cur.inq �ooiild be more crit�.cal� and stretigch
would nevelop ai: a slo�;er rate. If stif.`icient sti-er,gtL h�d not .
develo?�ed p*-i.oi- to the appJ.ication of the no�t-tension loaci a
major portiun oi inis load r.iay have been lost due to creep. ?9e
suc{gest t.hai: at. 7.ea;t one oi the sirains. be er.posed and the ter.sion
fo�ce determinecl. •
Respectf:ully sut�miited,
DA��T.D�.'DI� I�i:G & . Z�SSOCIAI^i;S
TSavia 1�. ]�
R:C.F. ].O1
TLi3: D�1D/1^d
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,
! D�:.�'Ib A.. D}�iZING'A7'dD AS�nCIfiTTsB
OWNER
LOT
GP5
$PRINKI
MISCEI
NOERGROUNO U POWER
.OUGN WIRING
rL00R SVSTEM
:JND BEAM � STEEL REINFORCE
:. iIEFTHING
+?AME AND FLASHING
-�STEq, BROWN COAT
fING, VENT., REFRIG. AND A,C„ FINAL
':MBING. F�NAL AN� 6/5 TEST � _
.�TRIC, FINAI
B111L�ING. FINAL
DATE
SUBCONTRACTOR
PERMIT N0.
-�-�'��,,� ��
4'' i
{� � � . ' �
�: 350��� � . • ' Pato�O�ooy+�' *��126.05
. � ,�ur_is-�<<�,a. .
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COSTA MESA BUILDING,SAFETV DEPARTMENT � � � . - .
- ZO1`. CR P•O. BOX 1200'; COSTA MESA, CALIFORNIA 92626 - � � . '� '. � -
- - - � � APPLICATION FOR`BUILDING�PERMIT � . �
� ; For Applicant to Fill in Completely . _ R CEI E B V- � DATE RECEIVED
' DA E ISSUED-
" . sui�oiN� - Jc- � . ` Dahlia Avenue � - - � �� •7�
ADDFE55
, . .. ... • PERMI. �� ' .
owNeR' . tarwin Southem California lnc. ^•P•"o — �`
Moi� 16255.Ventura Boulevard ooRe"ss S3 ���i
Z ADDRESS'_. ' _ Q � '
d U 'CITY . EflClllO�� COI I�OR110 �10L9p6�H9O '- TRACT � Q ' I LOT BLOCK '
� zZ;
'Q : CON5iFUC710N ' ' - ' W ' AOD A P •.
ON LENDER �LQIWfII 5 ��thern d ' .
am _ �. . .
JN BRANCH�� �6ZS5.V01�}�UYl7 BOUIBVQiC� Q�i,�NEfl ` �/T/..LPJ/•U �CZNe.
m� aooREss . Encino Califomia ui VALUE / U-�
J m ARCHITECT � ' ' TEL � SE � � : ��(�
a OI7ENGINEER LARWIN�� N .273-44 �
N T
W� aooaess • 9100 Wilshire Boulevard HIIIS -ZONE ' TVPE '.V GFOUP'
aw
W Z APPqOV -7��7 �'� .
Jo CONTRACTOR Lanvin SoVthern California B�' onre i f
m'z ' ' . . ..::-, , - -
��' nooaess 16255 Ventura Boule ar ' S ` ��/
� W w ZONE � NO.OF USE OF NEW /�U FAlM.�
z= arr Encino, Cdlifomoa o�9$6-8890 �� '�""'� � eui�oiNc �., 6�
�
—� STATE ' CITV '•YARDSAPPROVED� ' VAflDSAPPROVED
y� �,�. No. �` 191311 � ,�,o. No. -B-1 MAIN BUILDING . ACCESSORV BUILDING ,.,
�O � � � - � (F,ROM'�GLS ET) ;'; . '� -- '
SI2E` ' ` NO.OFBLDGS. .. , . , � .
� OF LOT 53 X LOO � NOW ON LOT.- Q FRONT FT.. FT.
VSE OF ' '
' EXISTING BLDG. . � � � � , :�� SI� . � T. � FT. . .•.
�H ' SIZE OF � � NO.OF . � - � � � - � � .
-Z -NEWBLOG. 1436 � ROOM$ STORIES .1 L.SIDE �� FT. FT.
, � U EXTERIOR WALL' ' �ROOF �„ � ' �� � C . , '
COVEPING SI'U COVEFING REAR �S�FT. FT: ,
J USE OF BUILDINGAND'WORK TO BE PEFFORMED DISTANCE BET. - �� BET. MAIN & ' - "
' a . • . ' . . . . '. . . ` ' MAIN BLD(35. ACCESS. BlDGS. . .
1
. Q , . . . VAR.# . ' DATE . ' '
p Construction Sin le Famil Residence • c.u.r.� ' � _, aPPaovEo
� " " . � . APPFOVED � ' . �J i Z
. y • � � � STA7E
�p . �
� .V I hereby acknowletlea rhat'I haoe reatl this application antl state �30LD FOR SPECIAL REQU NTS �
� �� that the aboJe into�mation,is cOrrect antl agree to comply with _ .
,� all laws regulating building construction,-and I shall not employ � _ �� -
F � any pe�son in violation Ot tFe�Wprkman's�compensation laws of - . . ' �
; y the State of'California. .'� ' � , •�, � � i, --� . � . �.: //�� q' y,} ' ��-
• z 1 hereby certify that I�am properly licensetl as a contrector untler � n. FT. �+l �/� Gl o•' o�
ffie State ot-California�Business antl P�ofessions Cotle, Divisicn 3, THE AMOUNTSHOWN UNDER VALUATION IS FOR �, '
. Chaptei�9,�antl ffiat.such licenses are;in full force�and etfect; or,l. ' THE PURPOSE OF ESTABLISHING A PEBMIT FEE ONLV: ' m �
am exempt trom [he provisions of the State of California Business . � �
vALVATION �� ' �'O � N�
and Professions Cotle, Division 3, Chaptar 9. � � "� pERMIT FEE $ �
, . . . ]
,. � Si9nature o't!a �' �^J �./' j. �� : . �� � • . ' . . . . - 5��,: m.
• Permittee•tC� �Pa' �. � . D. �OW $� � /Q�" ,. PLAN CHECK 5 � '� . E .
�y o,
. . . AuUiorizetl A9ent . ' . � ie •..� . . . . . . • � . � . '� . , � 'TOTAL FEE S � S� LL� '
, �.
�+ ` � � , y
YAIL
��?f:.fd ,. ��,i_=, ���;.;,on n�� �'.� �,��e.5c
� � �,�COSTA MESA'�BUILDINGSAFETY DEPARTMENT�� . , � � _ "
� � 'P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 , � - .
' } APPLICATION FOR STRUCT'[JRAL PERMIT �
.� � For Applic9nt to Fill in Completely�— Use Ink Only� , aeceiv DATE RECEIVED
/� D E I sueo
� �ADIDRESS �' 1�� � A N L I�I �. . . , // - � � � • .
� � . . A.P. NO. "/IZ'� %FI3 � �/Y. PEHMIT IL� l..
'� �OWNER�� �- � E
' MAIL . �. . , . , ' BUILDING [�,s'3 �nfjfi(/yf "A�/E . .,.
� ADDRESS ' ADDRESS cr
'� % GTV '.Us�[ " l-4 ".I�.' NOLS�CV91�. . TRACT 77'8 .A LOTj7 BLOCK . .
CONSiRUCTION' . - . . . ' " EW ADD L P
� LENDER � '' , '
�BRANCH 3 �.. . ' . .. � �+ .
� . ' , . . OWNER�' D Ti V`O�T�T . - . '
" ' ADDRESS ' " � � � - � �VALUE '
� ' ARCHITECT � � . TEL ' � � S $ .
OR ENGINEER N - .. „
- . - . . . FIRE `
ADDRESS' - ' " " ZONE' ' TVPE GROUP '
.. ' ' - . . APPROVED - . ' .
_ � CONTRACTOR 'U.��E � 8Y ' ' �DATE � � '
ADDRESS � , . • ' /iVrrii�G
� � . � ' � �� TEL . � ZON � ` NO.OF USE OF NEy�VN�(`W�uf _
�—( � PLANS BUILDING P
CITV . . • ' �NO. , - ' /N�TA<G tv/�+Y
• � STATE ' _ ' ^CITY � _, �'ARDSAPPROVED VARDSAPPROVEO
i �I0. NO. .� ' �'. L`IC. NO. '' MAIN BUILDING ' ACCESSORV BUILDING
, _ W SIZE .. , . ' . ' . NO.OF BLDGS.' ' (FROM GL STpEET)
• �. � OF LOT � NOW ON LOT RONT' FT. FT. '
a USE OF ' ,. . . . - ' ' . . ' . .
• � EXISTING BLDG. � � ' " r T FT'
h � s
S` � Separatepermitsaretequiredfor ' ' �.soe ,' i#i vr. .
0. electric, plumbing and heating work. REAR %' FT. Fr.
[.W.i USE,OF BUILDING AND WORK�TO BE PEfiFOIiMED . , OISTANCE BET. - BET. MAIN &
' Q ' ' MAIN BLDGS. ACCESS. BLIX'�S. '
� ' ^ � VAR. # . DATE
� ¢ / ^ � - C.U.P.qW.' ' qPPROVED. , � •
. � � � � ` , ^ ' i ' APPROVED '��,.�— � 7
}
� ' '.� , �'. . ' . -
�
a .
� � I'haraby acknowletlBe ffiat I have.read ihis applicallon anE state , . ' �
'' Q! that tha above.information is correct'and agree to comply with" m
� a � ell lawz reBulating building construction, entl.l shall.not employ , � , • a �' ' .
. �
z�, any person in vlolaSion of the workman's'compenution laws.of. m
� ' <he'S<ete ot Celifornia. - , - ` � _ - ' ' . . - � •
3 �I hereby.ca�tify'that,l am properly IicenseA asa�contractorunde� - SQ. FT.' - ' a
' . ihe Stata of Californfa Business end Professions Cotle, Divlslon 3, THE AMOUNT SHOWN UNDER VALUATION IS FOfl . m
' ' t Chaptar 9, antl that such licenses era in full torca antl effect, �or I� THE PUFPOSE OF ESTABLISHING A PERMIT FEE ONLY: �
� am'exampt from ihe provisionsof ffie State of,Califbrnla Business. VALUATION .. � a
' PERMIT FEE E
entl Professions Code, Divislo yChapter 9. O a � • D u�
m
�PLAN'CHECK E' �^ "�
' Signaiure of — / 0 - LL _ .
D o
Permittee �� � $ D r— TAX �5 v .�� � �
• � U
'Auffiorized.Agent � . ' ' TOTACPAID $ �.� /
/
C �