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Home My WebLink About205 DARTMOUTH PL - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�.�LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 205 DARTMOUTH PL Suite: Vicinity: RESIDENCE AND ATTACHED GARAGE Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 14145509 Zoning: Applicant: BATIOFF, JOHN Address: �'. Owner: RAHMANI, SOHEILA Address 205 DARTMOUTH PL � . , � �. COSTA MESA, CA' � " Contrectoi: A1 QUALIIY�ROOFING INC Address: 750 S LINCOLN AV , � , UNIT 104�' - ' CORONA�,CA � Zip: 92882 i Arch : - ".'' , _ Addre95:- � � , , � . ,� �Phone: Zip: License: � ISSUED BY: . � Phone: 714387=7974 Zip: Phone: - � . ". � Zip: 92626 � � . Phone: 909-808-4251 � ;License: 605240 _ � - - Eng: . .. i`. " , Address: Status: ISSUED Applied: 03/29/2005 Issued: 03/29/2005 Phone: License: � � a�.vre vr renmi i � , � REROOF RESIDENCE AND ATTACHED GARAGE: T/O EXISTING�COMP ROOF, REPAIR/REPLACE SHTG AS NEEDED, FELT PER MFGR'S SPEC, APPLY "CLASS A 50-YEAR COMP�SHINGLES." 28 SQUARES- - - --� / � - - -� ` " . , Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $0.00 $153.25 $0.80 $0.00 $0.00 $0.00 $154.05 � FEE SUMMARY , � __ __ _ _ _ ,: Calc Valuation: $e;000.00.� - _ - . , , . - Claim Valuation: ; ; Sa,000.00 ,': , � � � . ... . ,_; �_ . . , . .a_, - ' • � , PLANNING & ZONING � � � � "�� SETBACKS , � �� , � .� � MAIN STRUCTURE Front � 0- 0 Rear 0- 0 Left 0- 0 �. Right � 0- 0�, . ACCESSORY Front � 0-0 Rear 0-0 Left 0-0 ,�. Right •� �0-0' -" PARKING Existin i, 6�' Requlred: 0 Proposed: 0,, � ' NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendetl or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all �equired inspectlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 '496-461&00) WORKERS'COMPENSAnON DECLARAnON: I hereby eHirm under penelty ot perjury one oi Ihe tollowing declaretions: ❑ I heve end will meinidin e certificete ot cansent to self-Insure lor workers' compensetion, as pmvitled for by section 3700 of Iha Labor Cotle, for Ihe pertortnence of Ihe wark tor which this pertni� is issued. �.I have entl will meintain workers' compensation Insurence, as required 6y section 3700 oi the lebor Cotle, for the pertormance of the work for which this pertnit is issuetl. My workers' compensetlon Insur nce cerrier end policy num6er ere: Certier: �—� Policy Number: �Z.G} Q�i Z3Q �/ZC�C' � (This sectlon neetl no( be Co leretl il the permit is velued e1 one hundred dollers ($100) or Iess.J ❑ I certity that in the perfortnence ol the work for which this pertnit Is issued, I shell not employ eny person in any manner so es l0 6ecome subjecl to Ne workers' compensation laws oi Califomle, nd gree thet If I should become sub�ect to Ihe workars' compensatlon pmvisions ot Sacfion 3700 of the Lebor Code, I shell forihwith comply with these provisions. 7 Applicant Signeture: _ � Dete: � � rC—� � � WARNING: FAILURE TO SECURE WORNERS' PENSATION COVERPOE IS UNIAWFUL AND SHFLL SU61ECi AN EMPLOVER TO CRIMINAL PENALTIES AND GM� FlNES UP TOIXJE HUNDRED T110USAND DOLLARE (5100,p10I. �N ADDITION TO THE COST OF COMPENSATIqJ, DAMAGES AS PqOVIOED FOR IN SECTION 3/p60F THE LABOR CODE. INTEREST, AND ATTOFiNEV'S FEES. LICENSED CONTAACTOAS DECLARATON: I hereby attirm that 1 am licensetl under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 oi ihe Business ar� Professions Gode, and my license is in full force antl eflect. Lic. a' �^ Zy � Class p C�� Contractor'sSignature: _^R a� Date: {—)q—� CONSTRUCTION IENDING AGENCY: ❑ I hereby attirtn that tnere is a construction lending agency for the pedormance ol Ihe work lor which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lentler's Atltlress: Signature: Dete: OWNER-BUILDER DECLAAATONS: 1 hereby attirtn thet under penalry of parjury ihat I am E%EMPT FPOM THE CON7RACTORS UCENSE LAW for the followinq reason (SecJ031.5, Business anE Professions Cotle: Any city or county which repuires e permit to construct, alter, impwve, demolish, or repair eny stmcture, prior to its issuance, also requires ihe applicant for such permit to file e signed statament f�ei he or sha Is IlcenseC pursuent to tha proNsions of the Contractors Llcense Lew (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Bu5ine55 end Pmfessions Code) or that he or she Is exempl thefefrom end the 6esis for Ihe ellegetl exemption. Any violation ot Section 7031.5 by any applicant for a parmit subjects the epplicant to a civil penelry of not more Ihan live hundred tlollers ($500).): ❑ I, es owner of tha property, or my employees with weges es thelr sole compensation, WILL DO THE WORK, and ihe simcture is not intende0 or otteretl tor sale (Sec. 7044, eusiness antl P�o�essions Cotle: The Comracmrs License Law does not apply m an owner oi properry who builds or improves ihereon, antl who tloes such work himseli or hersetl or throug� his w her own employees, pmviAed thal such improvements are not intendetl or ottered tor sale. If, howavar, the buil0ing or improvemeN is soltl wiihin one year ot completion, the owner-builder will heve Ihe burden ot proving that he or she did not build or improve for purpose of sale.). ❑ I, a5 owner oi the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct Ihe project (Sec. 7044, 6usiness and Pmtessions Cotla: Tha contrectols License Lew does not epply to en owner of pmperty who bullds or Impmves thereon, and w�o contracts tor such prolect with a coniracbr(s) license pursuant to tne Conlraclors License Laws.). ❑ I em exempt untler sec. Businass and Prolessions Code tor this reeson: Signature: Date: Owner ID venfietl by dnve!'s licensa. es ❑ No Drivefs License No. Venficetion oi Ownership by (rypa of tlwument, i.e. - pmperty tax bill or deed): DIVISION OF INDUSTRIAL SAFETY VERMR CERTFICATON: Expires: ❑ I hereby certity ihat no exwvation tive (5) or more feet in depih into which e person is requiretl to descend, will be made in connection with work authonzed by [his permit, antl t�a� no builtling sWCNre, scaRoltling, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high, (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Calitomia Atlministrative Code). ❑ A5 ov.•ner�Duiltler, I will not employ anyone to tlo work which would require a pertnit from Ihe Division ot Intlusirial Safery, as noted aDove. unless such person has e permil Io do such wo� <<am the division. Signature: Date: Division ot Industnal Sefery Permit Number. CERTIFlCA7E OF COMPUN�ICE AND AUTMORVA710N OF ENTRY: I cenity under penalty of perlury Ihal I have reed this application and slate t�at ihe information given is correct. I agree to wmply with all s�ate lews enG city ordinances releting to building constmction, end emhotlze representatives of �he Gty ot Costa Mesa to enter upon the ebova-described property tor insDection puryoses. I agree not lo occupy or ellow xcupancy of any �uilding aulhorized 6y Ihis permi� until tinal inspection. COOE 1. INSVECTION TYPE 1618 Fixetl System Fina� Fire Prevention 1266 Paol Spe Final 200 Finel Re-Aooi 201 Final Block/Retaining Wall 202 203 Final Factory Fire Place Finel Sign 204 Final Demolition p�TE �NTRIALS Data ✓ � � 7 � � ) Dale COpE I INSPECTION TYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Electrical 212 Finel Fire Preveniion 220 Final Plenning Approval 222 Finel Site 250 FinalBuilding/Occupancy D�IE IHIIII�L$ Property Address CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION � Owner �!' �1� �'C� ��, � VVIa Vl � Contractor State Contractor Li�ense Number Permit No. �`� D� C �/ Classification � �� - =—T— I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 15, and Appendix 15 of the latest adopted edition of the Uniform Building Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the`property. (Owner-Builder permittee only). � I further certify that I am: �v�ol�-riw�- �� C�'�7�4C{� ❑ Owner ot sole proprietorship company ❑ Full partner of the company ❑ Limited partner of the company � Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shali be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Buitding Division for acceptance. Received by Buildirlg Division sy: 3 z5' aS nit Date 099Pa6 MW 6N0 W�ite- BuiWing Div; Canary� Cmvxta: Pink � Owna /-� � I a �,1,-�-,-� �o�'� � � . ompeny or Corpore Name `� .� 0 S. L� v.C`c I� �c �% D�/ AtldreSs C G�t cv��, ['�; 9 zt�8 Z �— ,3--Z� �� Sign�e` Date v .� ��. C� �-, o� Printad or Typed Name (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 lob Address: 205 DARTMOUTH PL Suite No Vicinity: Parcel Nunmber: 14145509 Applicant SAELEE, SURIN Address: 7229 VARNA AVE NORTH HOLLYWOOD, CA Owner: FLOYD-BROWN, ELLEN S Address 205 DARTMOUTH Pl COSTA MESA, CA Contractor: ALAP ASSOCIATES GP Address: 7229 VARNA AVE . NORTH HOLLYWOOD, CA� Arch / Eng : - - Address: WATER HEATER CHANGEOUT. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System. � Connect (Ice,Soda,etc) . Dental Units Dishwasher Drain, Floor Draiq Rainwater Drain, Roof Drinking Fountain Ezpansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY 0 PLUMBING PERMIT Phone: (818)407-1247 Zip: 91605 Phone: Zip: 92626 Phone: (818)407-1247 Zip: 91605 License: 771905 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 ` ; P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 R) $0.00 ��-Receptors $0.00 � Septic Tank $0.00 SewerCapforDemo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 Status: ISSUED Applied: 10/05/2000 Issued: 10/05/2000 ISSUED BY: � � _ EXI'I�D DA a D QTY � � ' -� .AMT 0 Sump Pump , � $0.00 '0.;,��:..7,_SwimmirigPool � � .�� $0.00 0 �= - '- Trap Frimer � � �� '� $0.00 0 -Urinal , i ' �$0.00 0 � ; � Vacuum`Brkr Bkflow(7�-4) � $0.00 0 � ' Vacuum BPk%Bkflow(5+)' $0.00 0 " � " �Wash.Basin ��, � $0.00 0 ' �' � Wash Basin�Set ' $0.00 0 , Waste and Vent System $0.00 0 Water,Closet (Toilet) $0.00 0 WaterHeater/vent $12.30 0 Water Piping (Ins[ or Rep.) $0.00 0 , , ' Water Re-pipe $0.00 0 Water Service $0.00 0 Water Softener $0.00 0 OTHER $0.00 0 VIOLATION $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 COMMENTS I SPECIAL CONDITIONS TOTAL CALCULATED FEES: E35.80 QN 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NO710E: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. ' INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all i required inepections and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the ezpiration ot this permit. i, FOR INSPECTIONS CALL: (714) 7545626 I 2448-68 (F✓W) WORKERS'COMPENSATION DECLARAnON: 1 here6y affirtn untler penalry ot perjury ona of the tollowing declarations: . ❑ I have antl will maintain e certificate oi consent to self-Insure for workers' compensation, es provided for by section 3700 of ihe Labor Code, tor the pertormance ot Ihe work for which t�is permit is issued. �Ll�ava antl will maintain workers' compensation insurence, as requiretl by section 37W of the Labor Cotle, for the pertortnance of the work for which this partnit is Issued. �Myw�rkers' cn atlon Insurance car'Ler3hd poli number are: ce�ner�^-��' �' ' AMER/�'A/1/ ALT,F".n/l/i/T/ �cy N�meei: �� oQ L+/Gl.('�O �fj�/O �' tThis'section need not be compleretl i/ the pelmit is valued ef one hundred dollars (3100J or less.) �--�-? ❑ I certiy that in t�e peAormance ot the work for which this pertnit is issueQ I shall not employ any person in eny manner so as to become subject b the workers' compensation laws of Calitomia, end agrea ihat if I shoul ecana su ct to ihe workers' compensetion provisions ot Section 3700 of tha Labor Code, I shall forthwit� comply with these provisia /� Appltcant�SignaNre:, �f�.- � Date: /�l�T—Od WARNING'. FAILORE'TO'SEWRE WORKERS' COMPENSATIdJ COVERAGE IS UNL4WFUL ANO SHALL SUBJECT AN EMPCOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED THOUSAND DOLL4RE �E100.000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDEO WR IN SEGTIOtJ 3]O60F THE LABOR CODE, INiEREST, AND ATTORNEI"S FEES. LICENSED CONTRAC70RS DECLARATION: I herehy attirm thal.l.am.licensetl untlerv rwisio foma and eflect.�Lic. # � � � / �%�� CONSTRUCTION LENDING AGENCY: of Chapter 9(commencing with Section 7000) of Division 3 Cotle, and my license is in tull ❑ I hereby aHirtn �hat there is a conswction lentling agency for the pertormance of the work for which ihis pertnit is issuetl. (Sec. 3097, Civil Cotle). Lenders Name: � Lenders Address: SignaWre: OWNER-BUILDER DECLARATIONS: Dete: I hereby atfirm that untler penalry oi perjury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Profeuions Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires tha epplicant for such permil to tile e signed statemem that he or she is licensed pursuant to the provisions of the Coniractors License Lew (Chapter 9(commencing wiih Section 7000) oi Division 3 of the Business end Professions Code) or ihat he or she is e:empt iherefrom and ihe basis for ihe allegetl ezemption. Any violation ot Section 7031.5 by any applicant for a pertnit subjecis the appliwni to e civil penalty of no� more ihan five hundred dollars (5500).): ❑ I, as owner of ihe property, or my employees with weges as Iheir sole compensation, WILL DO 7HE WORK, and Ihe swcWre is not intended or ottaretl tor sale (Sec. 7044, Business and Professions Code: The Coniractors License Ww does not apply to an owner of properry who builds or improves �hereon, and who does such work himself or herself or ihrough his or her own employees, provided ihat such improvements are not intentled or oflered for sale. If, however, �he building or improvement is sold within one year ot completioq the owneo-builder will have the burden of proving that he or s�e ditl not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the pmject (Sec. 7044, Business and Professions Cotle:�The contractors License Law tloes not apply to an owner oi pwperty who builtls or Impmves thereon, and who contracts lor such prolact wit� a contractor(s) 'license pursuent to the Contractors License Laws.). � C�� {� �' �� y Business antl Professions Cotle for �his reason: ❑ Pamaxemptundersec.-+� -� SignaWra: �' Date: Owner ID veritietl by tlnver's'licens�` ❑ Yes ❑ No Drivefs License No. Expires: Verification of Ownership by (rype of document, i.e. - propeny taa bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIPICATION: ❑ I hereby certify ihat no excavation five (5) or more fee� in tlep�h into w�ich a person is required to descenq will be made in connection with work authorizetl Dy this permit, and that no building siructure, scattoltling, falsework, or demolition or tlismantling thereof, will be more Ihan thirty-si: (36) teet high. (Chap. 32, Gry 2, An 2, Sec. 341, Ttle 8, Califomia Administrative Code). 0 As owner-builder, I will not employ anyone to do work which would require a pertnit fmm the Division ot Indusirial Safery, as noted above, unless such person hes e permit to do such work irom ihe division. SignaWre: Date: Division of Induslrial Safery Pertnit Number. CERTIFICATE OF COMPUANCE AND AIJTHORIZA710N OF ENTAV: I certify under penalty of perjury ihat I have reatl this application and state that ihe information given is correct. I egree to comply with ell state laws and ciry ordinances relating to building constmction, and authonze representatives oi the Ciry of Costa Mese to en�er upon Iha above-described propeM for inspection puryoses. I agree not ro wcupy or allow occupancy oi any building authorized by this permit until tinal inspection. C�il CODE �. INSPECTIONTYPE 1616 Fized System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PLTE ixmu�s CODE� INSPECTIONTYPE 206 Final Mechanical Oate G�—r'i0, �oate �- �g � 208 Final Plumbing 210 Final Elecirical 272 Final Fire PrevBNion 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy Pfl0.1ECTF00PES5: zOS DARTMOUTH PL OWNEfl'S NpME: F�LOYD ELLEN S aooxess: �OS D�.RTNOLTTH PL CUSTA MESA,CA 92G26 545-4522 FHCH/ENGINEEN: . IIOUXESS: nec.xo.: UNIT: UNIT: PEBMITTEE: xOGERS ROOFING ('li4)995-2g26 aooxess: 4912 LINCOLN CYPRESS CA 40630 IICEN5E0 CONTBACiOH �ECIAflFTION: I �ereby affirm ihat I am licensed untler pmvisions of C�apter 9(commencing with Section 7000� o� Drv�von 3 of the Business and Pmfessions CoOe. antl my license is in fu0 �ome antl e0ec1. cirr uc.: U 3 5 0 9 9 STATE L1C.: Q($ f i I 4 � S C 3 9 /�J Da�e: �� % �-' $igwmre: _ _ _�� WOBREflS' COMPENSFTION OECLABATION: I hereby a�fir have a certificale ol consem to selFins o cenificate of Workers' ComOensation Inmrance. or a certilie0 copy thereot �Seciion 3800. La�. C). voucrxo.: PWC1T194; E%P.ORTE: OZIZGI93 COMPANY: GOLDb'N EAGLE ] Ceniiied copY is Aere6y lumishetl. m Cenified caDY is ii wi �Ae ci�y Builtling �iv ion. , �Date: �� IO I L NpplitanL F%EMPTION FBOM W08REP5' fAMPENSl�tION OECIABATION: his seaion neea not �e completed ii the p it' or one huntlreA (5100) or lew�. I cetlity �hai in Ihe Oe�ormance of Ne work �or which this permit is issued, I shall no� employ any p s in any manner 5o as to Oecome sublecl �o �he WorkerY Compensa�ion Laws ol Calilomia. �ate'. Signature: ' NO710E: II. after making ihis declaration, you shoultl become su6lect to ihe Warkers ComOensa�ion provisions of ihe Labor Cotle. you musl fonhwith comply with such provisions or t�is permit s�all he OeemeO revoke0. CONSTBOCTION LENOING RGENCY: I here6y aifirm �ha� Ihere is a consimction lentling agency tor �he pertormance ot �Ae work lor which �his Dermii is issued �Semion 3W7, Civ. C). LENDEP: aoosEss: CITY OF COSTA MESA — HUILDING FERMIT PERM NO: $ US'739� PERNI!' NO: H 057393 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUC'tI01� T'YPE; V—N PERMIT TYPE: STR PURPOSE: ALT JOD DESCRIPFION ; T/OFF REROOF W/COMP. SQ r'T; 3,`114 CLAIM VALUE; 3,914,00 CALC—VALUE; 3,914,00 GftOGP OCC; R-3 / COMMEN'PS• SMOKE DETECTOR RE�UIRED It� THE HOME ��x�r�**�e��r*�t*xu��*��**�f� **��rx�**�*�t�r��xx��t��t�!*x**xu��*�**�**x��>�*��•xt+�. 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 ----------- MATN BUILDING --------- --------- ACCESSORY BGII.D3IJG --------- FRNT; FT IN REAR: FT IN FRNT; FT SN REAR; FT IIv LEFT; FT IN RGHT: FT ZN iEFT; F? IN RGHT; FT IN PARKING REp• PROV; FARCEL; 14145509 ZNE: REF NO: PLANNING NGTES> ( � .� l iE 1f iE ie 3F IE iP iF iE iF lf 1E i� iE �1Eif ic iE if jE K 1F if 1E iE lE ie �1f 3i # if fF i! iE 7F if iF IF �lf iF #'�'r� �k ic if �F ii iE if ik iE �If iE iE iF if 1e iF�li ii� 3?� iE iE if-iF iF k- Y.� ii� 3E lf i'r ii" iF }. ic iE �3i�-)r D E V E"_ L O P M E N T S E R V I C E S R E[J U I R c M E N'T' S 'LONING APPROVED� BY DATE: �:.�. 3UILDING APPkOVED BY ; DATa: !r APPLICATION ISSUED BY•� c� DATE; � jh')h'1E'IEIfIf'iI'IF±t'iEiEX-d%3Y.'YF9%3E'iI'iflF%#'' ' } N .F' �3Fi ' a�'I!'1FiF.. 'it'h'tt ' iE#I'i.'ii'iEiE"I%'k'i'r3%'1t�S cF '�ii�.��: . ...il''�. ii�if3Eif�iFicii�iElEiElFif�)fii��I?3EiE1(-3E?i}iE�IE'%�%�iFiEiC�K•#IFifiEitdFlEibk..'�x3FiE*R'F363fic1Eif3ElflFi(�-1cic3E�lfiEiflc�iE'1'r3fieifie'.ib?ti:F !F?f�1Fif!'riE LEGALIZATION;N F B E S U�„ A R Y STRJCTURAi.' BE�;McNT;Y OWNEP BUILOEB DECLAflFTION: I here6y attirm thal I am exempt iwm th¢ CAntractOrs' State License Law �or the ronawing reason BLDG PMT PLUN$ ING $LECT7� 1C MECHAN IC I(Seclion 703L5 Business antl Pro�essional,Catle: Any ciry ot coun�y which requires a Dermit �o wns�mct, al�ei, impmve, tlemolish, or p ERM I T 6�, � � repair any slruclure. prior lo its issuance, aiso requires tAe apDlicant for such permit to file a signed statement ihat hGshe is licensed pursuani �a Ihe pmvisions ol Ihe Contractors' State License Law (Chapter 9(commencing wilh Section 7000) of oivision 3 oi the Business antl Prolessions Code� ar ihai he/she is exempl therefrom and ihe basis lor the allegetl exemption. Hny violation oi Section 7031.5 6y PLAN . any applicant for a Dermil su�lecls ttle apDlicani �o a civil penal�y of no� more Ihan five hundred dollars (3500). ISS[]E FEE FIRE SMIP/RESa' GRAI?ING J �4 SMIF/NON,—RES 5 / l as owner oi the DmDeny or my em loyees wim wages as meir soie compensation, will no the worK, ana ihe BUILDTNG—DIV—> PERMIT ISSU$ PLAN—CHECK TOTAL PAS1.7 � DUE � stmcmre is not intenaed or o�ierea ror saie (s�ection 7044. Business antl Protessional Code: T�e Coniractors' State License Law TOTALS -- --> 6 3. 5 0 0, 00 0, 0 0 6 3, 5 � 6 3. 50 , 0 0 Coes no� apply to an owner oi a pmpetly who builds or imDmves �hereon, an0 who tloes such woB himselt/Aersel� or �hmugh his or ner own employees, pmvitletl tha� such impmvemems are not inten4e0 or ofierea lor sale. If, however the builtling or REVENUE- DIVISSON TOTA1..i$--> C_OLLEC'TED • 63 , SU OVER /S:-IORT • r' 00 improvemem is solU within one year of completion, the awner will have the DurAen oi D�ovinA �e/she tli0 noi bui10 or improve ro�meo�rposeoisaie). BLDG PMT PLtJMBING ELECTRIC NECHANIC FIRE SMIP/TOi GRADING,/.��AN—CHnCK I. as owner o� the pmperty, am exclusiv¢Iy coniracting with Iicense0 contractors ta cansimct the pmjeci (Section 7044, Business 6 j, Q � , 5 � � ❑ antl Professions Cotle: The Conlractors' Sta�e License Law does no� apply lo an owner o� pmpehy who hwlds or impmves iherean ,�}�' an0 who contracis for sucA projects wilh a conVactor�s) license pursuant b �he Con[ractors' Sia�e LicenSe LaW�. I am aWare 1'r1f iE iE 1F if i'r iE-%dFiF iEiE iE iE 1EiF iE iFiF if 1FIFiE 3F34 k ie i'r iF IFiE ieif if iF 3E iF 3f 1F1E ff ifiF if #fjf ibaF # M i'�k3h 1E d'riE iE�k ?EiE iFiEif IF iEiE iE'1f if ieaE ifieie iE iE iE 3f that pmol of iheir Warker's ComDensation insurance shoultl be pmvitletl ro me. T N D I V 7 D U A L F L$ $ R E T1 K D O W i�7 � I am exemp� untler Section: B. 8 P. C. mrinisreason: TYPE �TY D E S C R I P T I O N UNIT COST 1�OTA"L COS" Date: Owne[ I tlo hereby certify �ha� I am aware of an0 underslan0 �he requiremenls o� Cali�ornia Healih and Sa�eiy Cotle Sec�ions 255U5, 25533, antl 25534 and I�at I or any future building occupant willlwill not (circle one� nee0 to comDly with saitl state ca0es antl Ihe requiremenis for a permil far cons�mc�ion or motlilicaiion Irom I�e Air Oualiry Managemenl DisUicL FesiOential tonstmction aDPlications are exemp� irom Ihese pmvisions. Date'. ApplicanL I h¢rehy certity��ai I have read Ihis appliCalion ana sial! ortlinances and siale laws relaling �o builtlmg conS�Nction pmpetly lor insp(ection Ou7rpo�ses. Date: �'� I1l _ �v Signature: Dd�er's Ucense or Soc�ai Sea�ity a: � above in�ormalion is correci. I agree �o compty with all ciiy and counry yay��orize representalives o��y1�Y �o enier upon ��e above-mentioned 164LG6 W�ne—Builaing; Green—Cotle Enlorcement; Canary—Applicant: Pink—Revenoe; Goltlenrotl—Assessor i SFR 3914 REROpF BY VAI,UE kESIDENTIAL AIQ20NE 1,00 �' 3,514,OU r.ND OF r EES ; �T' � r, i i ��" 0I 04it.`•Z04-lGi1v2t1` --�_t?" 1 OAi�� C5/!E�°3 T:MF: 13r5s f - . -. CONSTRUCTION AND PL-ANNING POOL a SPA �� ' Date � Inspector Date Inspector APPROVALS _ Permit # , � . - _ APPROVALS Permit # � 1. Temporary Electrical Service or Pole ' _- '� � 52. �Pool & Equipment �ocation - 2. Soil Pipe�Undrgmd. '. � 53._Steel Reinforcement �' 3. Electrical Conduit Utiiitv-Undrgrnd. � - 54. �Forms - �� 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - � 56. Rough Piumbing & Pressure Test 6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNiTE 7. Footings � 58. Electrical Conduit-Undrgmd. �- 8. Foundation , 59. Gas Pipe, O Undrgrnd., _Test ' 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap,_ O Undrgrnd. 10. Structura� Floor System ' - 61. APPROVAL TO DECK _ 11. Property Sewer Line & House Conneciion 62. Backwash & Receptor-Final � 12. Sewer Cap , 63.,Heater & Vent-Final '� 13. Roof Drains � . 64. Plumbing SYstem�� Final 14. Rough Plumbing � 65. Electrical-Final � 15. Rough Electrica6Condult . 66. Solar System-Final � 16. Rough Electric Wiring 67. Fencing & Access Approval 77. Rou9h Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceilin9 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. Ducts, in Structure 70. Underground Hydro 22. Ducts, VBntilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof ShBathing _� ,Q. �(,��i 74, pverhead 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 i 78. FIRE PREV. FINAL � 30. Drywall Nailing ..�� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � � 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' 80. FOOO CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heeting & Air Conditioning ' �j 35. Finai Ga5 P�Pe-Test ' � � - 36. Hood or Canopy � � :` 37. Final Factory Fireplace , , � � 38. Final Plumbing 1 _ 39. Water Service-Final � 40. Gas Service-Final ' � 41. Solar pomestic-Final � 42. Backflow Preventer ! � 43. Backflow Irrigation 44. Landscape Irrigation System � 45. Sound Attenuation 46. Handicap ReguVations - 4Z. FINALSTRUCTURE&BUILDING �Z2-�Z�jw�•� �'w.r� _ � � L� Lv�� /`' 48. FINAL PIANNING �� /' 49. Electric Release to Edison _,_ �� 50. Gas Release to Southern California Gas Co �,- '�/ 51. CERTIFICATE OF OCCUPANCY No. Date ,_� I � CITY OF COSTA MESA BUILDING DIVISION ROOF COVERING CERTIFICATION r ''_vi Permit No. U �-/ / �� Property Address 2�� .i/ �-T�� T L• l a)S� Y�� (� Owner Z�� `-� � Contractor State Contractor License Number yb OlS �� Classification l_ �� I hereby certity that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. ❑ I further certify that I am the owner of the property. (Owner-Builder permittee only). ❑ I further certify that I am: ❑ Owner of sole proprietorship company �Full partner of the company Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division By: /� L I Date 0990-a8 W�itaBuilEing Drv: Canary-Comraaw: Vink-0wner Printed or ryped name � • /-N � , � �ii�'�.0 COSTA MESA BUILDING DEPARTMENT P.O. BO% 31� COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN laui�oiNc ADDRE55 OWNER MAIL ADDRE55 ARCHITECT OR ENGINEER ADDRE55 COSTA MESA. CALIFORNIA Dlke & �EGnL LOT DESCRIPTION NO. A.P. NO. SIZE OF LOT 7O S USE OF E%ISTING BLDG. TEL. �.al;p No � LIC. d].ebrook�o. 4B e oV$rv uc. ' �n� � No. R�+�- il Sli• TNO � BLOCK TRAC NO OF 0LOG5. NOW ON LOT SETOnCK LINE FftOM O' REAR YAR� q9T CENTER OF STREEt SIOE YARD RiGH t LEFT 1 � DESCRIPTION OF WORK NEW A ALTERATION AODITION REPAIR � MOVING DEMOLISH BUtLOING NO.OF SIZE ROOMS STORIES COVERIINGWALL St CCO COV�ERING C USE OF NEW fEE RECEIVED 10 - i y-S� fINANCE DEP% c�n of cosrn e� APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PFfj�l}T�I* iveo er on COSTA MESA. CALIFORNIA FIRE ZONE APPROVE� BY with attached garage. Plan 110AR I XEREBV PCKNOWLEOGE THPT I HPVE READ iH15 hPPL1CATION 4NO STPTE THAT TME 1�90VE I$ COFRECT ANO RGREE TO COMPLY W!TH iLL CITY ORD�N4NCE5 AND STRT �AWS REGLILATING Bl11LUING CONSTRUC� iwr�. � //�/�/ A VALUATION SIGNATURE OF � Y— ,�//a � // PERMITTEE f �f" A . IAIJTHOFIZEO AGENT ��B � CORRECTIONS $ 13,919.00 0 PERMIT FEE $ J<�O/�O^ PLAN CHECK $ ��w TOTAL FEE $ �� Mr owrrER YAT.� PRGPERTIES DATE 10-1'7-58 JOB ADDRESS 205 Dartmouth P1ace BLIILDING PERMIT NO. %�i10 GENERAL CONTRACTOR Dike & Coleerove � vaLUE g l�g� q_pp _ AP. No. LOT 13 TRACT Q�55 FIRE ZONE DESCR[PTION OF WORK Res. & Gar_ GROGP I& J TYPE V ' ZONE R-1 PLAN NO. DATE � SUBGONTRACTOR coat PERMIT$ ISSUED O - 99 5 � . COS?A MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 317 COSTA MESA. CALIFORNIA' FOR APPL/CANT T0 F/LL /N COMPLETELY � � TYPE OR PRINT BUILOING � �. .� �. _"f'� .dJ rli COSTA MESA, i . c� �.�:�x--�-y �LEGqL ILOT OESCfi1PT10N NO. USE OF EXISTING BLDG. SET9/CK LINE FROM LIG � NO. FIRE SONI STATE r �APPF IQ NO. J BY q9 ZONE BLOCK ITRA T� APPF BY INO. OF BLDGB. i veer DESCRIPTION OF WORK� REPAIR I BUILDING' SIZE' EXTERIOR WALL COVERING USE OF BUILDIN NO. OF ROOMS ROOF COVERING � r � �EE �ECEIVED �UL 16 1959 FI�nN�E nFpT APPLICA ION� FOR P_ERMIT ��BUIL�DING tJH fo,e offic� usF aacy I RECEIPI' NO. I 2EfiMIT BY COSTA MESA. CALIFORNIA TYPE GROUP ZONING NO. OF rt I USE OF NI PL�N9 eU1LCING (CENTER LINE STJ r�� na / V L.Ye � t r �' 7" /V J(��/�/ . > � , �»+.r�y I HERE6V ACNNOWLEDGE THqT 1 HAVE AD THIS APPLICNTION THE AMOUNT SHOWN UNDER VALUATION 18 FOR THE ANO STATE THAT TNE ABOVE IS CORRECT AND AGREE TO COM- pURPOBE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY OROINANCES AND STATE LRWS REGULATING BUILDING CONSTRLICTION. yqLUATION � SIGNATURE OF 1 � /'� 3� .� PERMIT FEE $ / PERMIiTEE ��{2 � ', `1 �� $ � 3� �_=- PLAN CHECK S i=1!i i �v �� AUTHSRIZED AGENT / / � TOTAL FEE $ � '� OWNER FLOYD, HER.MAN (P'II'. aYld MT'S. � DATE �-16-59 7os rwvxEss 205 Dartmouth Place Buir.Dixc rEaMiT No. 9915 cox'ritncTox E. W, h�tsmix�er AP. No. INSPECTIONS Form 310-3M-4-59 r v CT FIRE ZONE DESCRIPTION OF WORK block W3�.]. DATE I GROUP TYPE ZONE R�. —I SUBCONTRACTOR I PERMITSISSUED _,. 2E6 -� FEB 10-67cnsa00 505'•` t*'6 -`13.50 � COSTA MESA BUILDING-SAFEfY DEPARTMEPR ! P. O. BOX 7Nq COSTA MESA� CALIFORNIA 9282E - For Appl7mnt fo FIII In CompleNly ArPLICATION FOR PERMIT TYpE OR PRINT BUILDIN� o��oiNa / p for Offlcv Ux Only ADDHHYG L \ � � RtC[IA' NO. 1[11N-� COSTA MESA. CALIFORNIA R[C ViD�Y O LR[C[IV[D MT[1 BUHD _ �°r S'. � /0- -/�%6 DU,N�R D5 LP�-L.��L�.C.Lt�d eui�otno MAIL iJ .�` L O U ` /', Lf � ADDRi ADDR //�t+) // l i/ � e OLS'4S� RIR6 C�,�,Y ZON6 � TYF OROUP ARCNITECT TgL[,�� BrPROVQD � DAT6 � ��_� ORENOINHBR N . 7�'p( ZONING ADDRHIID / � "` � • ZO NO.0/ UB[O�N[W �_ ►uns a eu�t ix CONTRA L✓ �y /J ADDR t�' ��►TION t U/- � ,/ T�� CITY � A. P. NO. /` /�� _ GJ BTATE �4 NOT6: NO EAVE OVERHANO BXALL B8 LleB THM1 LIC. NO. N 80' TO HIDE R REAR . L. EAVE9 SIZE a O NOWONLOT I ALLOWHD fU.B.C.RECUIREM6NT) OF LOT USEOP YARDSMPROVED YAROBMPROVHD / 'EXIBTINO BLDO. i MAIN BUILDIN6 ACCfi880RV BUILDIN6 (PROMC/LYT [LT) 88iHACl( LIH[ PROM I PR NT � PT. C6NTHR OP @lR88T s R� Y,� � CID YAR LRR R10lTT R.� ID FT. o¢scwrnoN oF wowc L 8ID ��. �. NEW /V. RATION ADDITION R6AR R' PT' D18TANCQ BQT. BET. MAIN Q HEPAIR MOV�NO DCMOLIBX MAIN BLD06. ACGE63. BLDOH. � BUILDINO NO.O� VAR.# DAT6 ' SIZH HOOMB •BTORI C. . MPROVHD CO ERIN6WA CCD COVBRINOFa Q � ARROV[D DAT6 �/��(�/ UiiO!lUILDINCANDW�RKM P[ ORM D� . � {y '(+� �' �%kl' 07 �' - d l�Sn.r � BC. Pr. � 1 Hmt6GY ACKNOWL6DOt TiAT.i N�V6 pND TXIO A�'LIGTON TH[ AMOIINT tNOWN UMOCR VI�LUIITION IB FOR THi � AND BTAT6 iXAT TML ASOY[.18 CORRBG} ANO AOp6[ 1'O COY. ��Pro9[ O► {fIAlL18MIN0 A P6pY1T Fi6 ONLY. PLY WITX ALL CITY OROINANCi{ AryD RATi tAW/ R[OYtATIN3 ypLUATION � GUILOINO CON6}NyR10N. � P6RMITT6lOr --" . L ��ippy//�� •' PERMITFHB �� 8 /{' /�� •d0 w AUTXORIZ[DAOtN'[ / / � /"1 TOTkL PL• E J' �> (l �vrivr.0 nnvrviv. ru'. a mc-a.- �. �. ZONE )UP I TYPE SUBCONTRACTOR G 1V V� PERMIT NO.