HomeMy WebLinkAbout1021 DAMASCUS CIR - Building PermitsCITY OF COSTA MESA
05tH M�cs9 BUILDING DIVISION
Ft 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
"'°"�`°'� PERMIT NUMBER: BC10-00421
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: RES—ALT DATE ISSUED: 09/17/2010
ISSUED BY: CAC
JOB ADDRESS: 1'021'DAMASCUS�CC' M Suite/Unit:
APN: 41237138 Zoning. R1, ,
Vicinity: - Primary Occ:
Const Type: SQ. FT: - 0- -.Valuation: $1,500.00
SCOPE OF WORK: INSTALL NEW SHOWER TILE AND HOT MOP. 1 FLOOR DRAIN
OWNER: YARDLEY, ROB Address: 1021 DAMASCUS CIR -
Phone: City/State/Zip: COSTA MESA, CA
APPLICANT: JAMES WALING - Address: 647 CAMINO DE MARES
Phone: 949-278-8945 City/State/zZip: SAN CELMENTE
CONTRACTOR: SECOND MILE TILE .
Phone: 949-278-8945
Cell:
ARCHITECT:
ENGINEER:
COMBINATION PERMIT FEE SUMMARY
Building Plan Check:
Building Fees:
Electrical Fees:
Mechanical Fees:
Plumbing Fees:
SMIP Residential:
SMIP Commercial:
Bldg Std Admin Fund
TOTAL FEES:
License No. 815805
Address: 647 CAMINO DE MARESUnit:
City/State: -SAN CELMENTE
License No.
License No.
$0.00
$54.00
$0.00
$0.00
$33.30
$0.00
$0.00
,$1.00 -
$88.30
Unit:
Unit: :UNIT 108-203
UNIT 108-203
ZipCode 92673
PHONE:
PHONE:
'Refer to fee receipts for all fees paid for project
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279I`'='�--0�--
Monday thru Friday -7:00 am thru 7:00 pm. Saturdays. 9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays:
New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE N. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1286 Pool Spa Final 208 Final Plumbing
200 Final Re -Roof 210 Final Electrical---------,.---�
201 Final Block/Retaining Wall 212 Final Fire Prevention ,l ,
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site �/
204 Final Demolition' 250 Final Building/Occupancy /� jD •y�10 M
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier:
(This sedan need not be completed tlthe permd is valued at ane hundred dollars ($hXh or less J
kcyNumber
I :
.— certify that in the performance of the work for which this permit is
ed, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor Cotle II fo hwith comply witfi-these provisions. � \
phwm's Si are ate
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
inyAieQnse is in full force and effect.
eO
Cotr -
tactors5 nature Dam
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Date
OWNER -BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).0: ,
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the owner -builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for such project with
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature Date
3057-46(3/07)
Owner ID verified by driver's license. ❑ Yes ❑ No
Driver's License No.
Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depth into which a
person is required to descend, will be made in connection with work authorized
by this permit, and that no building structure, scaffolding, falsework, or demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 341, Title 8, California Administrative Code).
❑ As owner -builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from the division.
Applicant's Signature
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reported
year a quantity of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature and pressure).
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 65850.2 of the California Government Code requires that the requested
information be furnished on applications for non-residential building permits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signature Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final inspection.
lSg�r�ture-¢Legal Owners) � Date
An rAu1An honze pplicanl
O
PROJECT ADDRESS:
OWNER'S NAME: 1021 DAMASCUS CI
ADDRESS: SIMMONS, ROBERT H
SIMMONS, SHARON L
1021 DAMASCUS CIR
COSTA MESA,CA 92626
ARCHIENGINEER: REG.NO.:
ADDRESS:
UNIT:
UNIT:
PERMITTEE:
ADDRESS: PRIORITY ROOFING (714)837-8061
2�2T9(82RDpUNNgEFMEAR n n
LICENSED CONTRACTOIrOECLgATION9i h£re§y 2ffirm that I am licensed undery&isingA14pQr 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect.
CITY LIC.: STATE LIC.:CLASS:
059268 6419'%.hif. �e
Aye: _nN -9's•s Signature:
WORKERS' COMPENSATION DECLARATION: I hereby affirm tha ha a ce icale of copse o II-insU or a cenilicate of Workers'
Compensation Insurance, or a certified copy thereof (Section 3800, La
POLICY NO.: EXP. DATE:
CD ANY,
ElCedifi copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is
certify that in the performance of the work tar which this permit is issued. I shall not a toy any person in
hundred (5100) or less).
mer so as to become
subject to the WorkersCompensation Laws of Californf \
Date:\\ —\ — 9 Signature:
NOTICE: If. after making this declaration, you should become sublet to the Wor rs' Compensation pto ^el the Labor
Code. you must forthwith Comply with such provisions or this permit NWLt deraDed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civ. C),
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the
❑ structure is not intended or offered for sale (Section 7044, Business and Professional Cotle'. The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered for sale. II, however the building or
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I. as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(S) license pursuant to the Contractors State License Law),I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section: B. & P. C.
for this reason:
Date: Owner.
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will not (circle one) need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that l have read this application and state that the above information is correct. I
ordinances and state laws relating to building construction and hereby authorize refidesermadves of tl
property tar Inspection purposes. \�\
Date: —SQ) Signature'. \
Driver's License or Social Security a:
164146 White—Building: Green—Code
all city and county
a above mentioned
Pink—Revenue; Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 064701 PLAN CHECK NO; N
CONSTRUCTION TYPE: V—N
PERMIT TYPE: STR
PERM NO: B064701
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION T/O 6 REROOF CAL—SHAKE "5,6PSF" SQ FT; 11,000
CLAIM VALUE: 11,000,00 CALC—VALUE: 11,000.00 GROUP OCC: R-3 /
COMMENTS: INSTALL CAL—SHAKE I,C.B.O 2882, SMOKE DETEC, ARE REQ. PER9I,UBC
aF OF BE BF �F iFlf Tf BE iE iE iF yf fE 4E iF iF if ik of if iE#if iE**iE fF*3E aF it dE ielFlE*1E IE if #f fF if if la iE *iF aF ae if aF asiF ar. {F 4F jF nF iE iE
ZONING REQUIREMEN*SVOW!DE' C1 R
------------ MAIN BUILDING _____S—E—T H A—C—K S-- ACCESSORY°!�►QUI,RED ------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR: FT IN"
LEFT; FT IN RGHT; FT IN LEFT: FT IN RIGHT: FT IN
PARKING REQ: PROV; PARCEL: 41237138 ZNE; REF NO:
PLANNING NOTES>
iE 4E 4E if fE iE jE iE it lE iE ie iE iE ie*iF if ii*iE 14 iE it iF lE iE*1E iE*iF iF iE iE iF iE iE kiE iE if lE iE lE if ii iF jFM iF#'r*eE of iF*{F iE 1F aF k iF iE**K1E iE iE iF jF ?F {F iE iF afir iE aE
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: '
+APPLICATION ISSUED BY:
*DATE:
iE ie iF'lE fE * * �E iE iE iE k 1e if ie iF 1E ie fE BE 1f TE if 4F ie jF iE 1f iF ie iF iE if iE iE iE 4E 1E * 1F iF iF iF iE ie iE * iE ie M 4E 1f k if 3f if Tf iE iE iE fE k # B41F iF lE iE i! if i'r it iE 1r i4 iE iF iE iE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 126,00 1 10
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS ---- > 127,10 0,00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
126.00
SMIP/NON=RES
TOTAL PAID DUE
127,10 127,10 ,00
127,10 OVER/SHORT: .00
FIRE SMIP/TOT GRADING"PLAN—CHECK
1.10
iE iE iF iE if �E iE*iE*jE it l6 iE iE iF iE iF ie*3E*ie aE*iEl6 AE iE*3E*iF iF ie*il 1E lE iE iE iF iF iE iE 1r JE*ae fE iE iF iF ee ie if.*iR iF iE eF iF if iF iF iF iE iF aE iF iE ie iF iF iF iE 1E iE 1E
I N D I V I D U A L F E E B R E A K D,O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 11000 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 11,000,00
END OF FEES
1
01 0010903-00149904 TICIT 127.10
uHT 11!01!53 Tltic'.: 09:54
CONSTRUCTION AND PLANNING
APPROVAL$ Permit #
Date
Inspector
r'OOL &SPA
APPROVALS Permit#
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
-
9. Water Pipe-Undrgrnd,
10. Structural Floor System _
60. Backwash Lines, P-Trap, 0 Undrgrnd.
61. APPROVAL TO DECK
I
11. Property Sewer Line & House Connection62.
Backwash & Receptor-Final
j
12. Sewer Cap
63. Heater & Vent-Fina!
I
13. Roof Drains
64. Plumbing System - Final
14. Rough Plumbing
65, Electrical-Final
15. Rough Electrical-Conduit
66. Solar System-Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19, Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70, Underground Hydro
22. Ducts-, Ventilating
71. Product Piping 0Gas ❑Oil
23. Gas Pipe-Rough & Test
72. Underground Flush
24. Roof Framing -
73. Undergrnd. Storage Tank OGas ❑Oil
25. Root Sheathinc
74. Overhead Hydro
`
26. T-Bar Ceiling (Structural; & Monocoat
75. Dry Chemical
l�
27. Frame and Flashing
76. Dry Standpipe
28. Lathing & Siding
77. FIXED SYSTEM FINAL
29, Insulation
78, FIRE PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter-Final
80. FOOD CERTIFICATE ISSUED
33, Final Electric
Notes:
34, Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
�.
37. Final Factory Fireplace
38. Final Plumbing
1
39. Water Service-Final
40, Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43, Backflow Irrigation
44. Landscape Irrigation Systerti;.n
..z
45. Sound Attenuation
46. Handicap Regulations . e.i
-
47. FINAL STRUCTURE & SUTMING
48. FINAL PLANNING
49. Electric Release to Edison
- -
50. Gas Release to Southern-California Gas Cc
51. CERTIFICATE OF OCCUPANCY
No. Date
PATIO COVER DETAIL 6/1/67
SIZE SPACING ar 01 t�
OVERHANG_ RAFTERS: "g S , 6 - •� ` a +
STATE L t/'
SPAN
MAiF
I 3/g x 5'Lags 32%
�4•%o MAXIMUM---^ 'Predrill Ledger
Predrill Existing '''A'3 Deep
JOIST HANGER
or other approved methods
BEAM/ of support • tie.
' x •
STATE SIZE
ALL iI 3/16X2"-T-STRAPI II I CONSTRUCr1ONOGRAAF UGLAS FIR
0 Y..I
2
s
z
POST -BEAM
CONNECTION
PbST_ "
�7,
SHOW SIZE SHOW SPACING
SHOW. -LOCATION ON REVERSE SIDE.
.0
+— SLOPE 1TO DRAIN
DROP PATIO FLOOR
. • '... o.: •:.:3r THICK SLABAk
o.
PUDDLEDSAND_ FILL•
Remove Grass And Weeds Down To Natural Grade
CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT
POST ANCHOR...'.' 7# GALLONS PER SACK CEMENT.
For Pipe Post. Embed �12� Provide 26 Go G.I. Flashing At Wood Floor Cot
Pipe In Footing.
Provide Flange Or Weld Plate Screwed Or Bolted To Frame.
FORM BU -.o
CONTINUOUS
LEDGER
TYPICAL JOIST ANCHOR
NOTE: USE REVERSE SIDE FOR PLOT PLAN.
NO I 17�
FOR OPEN EGG CRATE
L%' 1 r_rx
h A
I NO 2
FOR SOLID SHEATHING.
ALUMINUM OR PLASTIC
SHINGLES OR BUILT UP
ROOF COVERING
ROOFING.
MAXIMUM SPAN
SIZE
SPACING
MAXIMUM SPAN
17' 0"
2 x 6
12 %
15' 1"
16' 0"
2'x 6"
167%
13' 3"
15' 0 "
2'x 6'
24 °/C
10' 11-
1 2' 0"
2-x 4"
1 f%
9" 11"
11, O"
2'x 4'
1&/.
8' B-
10' o"
1 2'X 4•
1 240/.
7' 1"
NOTE: FOR PROPOSED OR FUTURE ROOM,OR WHERE PATIO
WALLS ARE TO BE BUILT. USE NO.2 CHART ONLY.
WIDER RAFTER SIZE MAY BE INTERPOLATED FOR
SPACING ONLY.
FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO
WALLS ARE TO BE BUILT SUBMIT COMM HOUSE
AND ADDITION PLANS
r
9
�� 7
STRUCTURAL APPROVAL ONLY
SEPARATE PERMITS ARE REQUIRED
FOR ELECTRICAL, PLUMBING,
HEATING, VENTILATING AND
REFRIGERATION WORK
p�dP991$ #1_
THIS NUMBER MU,T ACCOMPANY
ALL INSPECTION REQUESTS
FOR BUILDINGS WHEdE PERSONS ARE 7p
BE EMPLOYED, WE SUGGEST THAT THE
STATE OF CALIFORNIA DIVISION OF
INDUSTRIAL SAFETY BE CONSULTED FOR
ADDITIONAL REQUIREMENTS.
RG/pHM
�' Of a4 deso B it ll.. I,
'n t PIANS MUST BE ON JOB AT ALL
MAKE NO CHANGES WITHOUT PRIOR APF
OF DEPT,
THE ISSUANCE OOF R GRANTING OF A PERMIT OR APPROVAL
NSTRUED
TO BE PERIJITNAPPROVAL OF, ANY
SPECIFICATIONS
OR ANAPPROVALOF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE.
SLIMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO
FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS (AWFUL.
THE ISSUANCE OF A PERMIT BASED UPON PLANS AND
SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL
FROM THEREAFTER REQUIRING THE CORRECTION
IN SAID PLANS AND SPECIFICOF ERRORS
OR FROM PREVENTING
BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN
IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE
OF THE ClDr.
OWNER STMMONDAt RCRF.RT DATE 7-31-78
JOB ADDRESS 1021 Damascus Circle BUILDING PERMIT NO. 46476
1 FIRE ZONE VALUE $ 529.00
INSPECTIONS
Si nature Dote I
TYPE v GROUP
T . ZONE
sols
SUBCONTRACTOR
A5
Dote Number Si nature
WATER
Plumbin
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
1
`TEMPORARY SERVICE OR POLE
UNDERGROUND POWER 0
ROUGH WIRING
NOatiR and Vent.
TRENCHE5 I FORMS D STEEL REINF.
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
Q
LATHING — IN OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TEST
ELECTRIC. FINAL
BUILDING. FINAL
SPECIAL REQUIREMENTS
f�,`
a
r
4V476 13.3_3' iV3i%7.8_ -'I-
C�XKA MESA BUILDING -SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA, CALIFORNIA 92626
PLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Use Ink Only
t� R C I D DATE RECEIVED ATE IS UED
WILDING I��..� / t
DORESS DAmA s c us _✓.�
/ RMIT N
v OWNER 2G G2 v- �� m rn /VS A.P. NOIi ��
MAIL BUILDING
ADDRESS Sa�� ADDRESS �,ZI
V TEL. TRAC LOT-~ BLOCK
CITY �� I ` NO.
CONSTRUCTION NEW ADD ALTER R PA
LENDER
BRANCH
_ OWNER C
ADDRESS VALUE
ARCHITECT ,� TEL. SE $ OR ENGINEER NO
FIRE
ADDRESS ZONE TYPE GROV �� /
ONTRACTOR QWAJ Q,(t-. BYPROVE DATE _ J7{ '
6:'60' TL
ADDRESS
ZONE
NO. OF
PLANS Z
USE OF NEW
BUILDING
TEL.
CITY NO.
all laws regulating building construction, and I shall not employ
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LIC. NO.
MAIN BUILDING
ACCESSORY BUILDING
SIZE NO.OF BLOGS.
%FROM C/L STRE
State of California Business and Professions Code, Division 3,HOWN
OF LOT NOW ON LOT
FROM
FT.
USE OF
X t
TAX $
EXISTING BLDG.
31 FT.
FT.
- Separate permits are required for
L. SIDE �'i
444)l
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
OCT 21-77PA" {} ***
001080 373.02
fIISA
PP IC TION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
R C ED V
I DATE RECEIVED
p�TE SSUE
(/ —�7
BUILDING
ADDRESS /o2I
�(.s.7 PERMIT NO.
OWNER FO= FAMMY TRUST
A.P. NO. f%
BUILDING
MAIL
2101 E. Fourth St., #100
ADDRESS 1021 Damascus Circle
ADDRESS
CITY Santa Ana, CA 92705 No'543-9471
TRACT LOT
BLOCK
CONSTRUCTION
U.C.B.
W
O ALTER P
LENDER
X
BRANCH 1010 N. Main St.
OWNER
ADDRESS Santa Ana CA 92704
LW LDS od
ARCHITECT TEL.
S
OR ENGINEER No.
FIRE
ADDRESS 77 S. 1 OrangeZONE
PE GROUP
APPROVED D /�
77
T....
CONTRACTOR Fole COI1St.TUCtlOn CO. 114.
ev DATE
ADDRESS Same as above
TEL.
ZONE/%
/
NO. OF
PLANS Z
USE OF NE
CITY NO.
/�
BUILDING
STATE CITY
YARDS APPROVED
YARDS APPROVED
LIC. NO. LC. NO,
MAIN BUILDING
ACCESSORY BUILDING
SIZE
NO. OF SLOGS.
IF ROM C/L T3EET)
S
OF LOT
NOW ON LOT 0
ROW FT. G
FT.
USE OF
EXISTING BLDG. N/A
F
Separate permits are required for
L. SIDE FT.
FT.
electric, plumbing and heating work.
REAR a,D FT.
FT.
USE OF BUILDING AND WORK TO BE PERFORMED
DISTANCE BET.
BET. MAIN &
MAIN BLDGS.
ACCESS. BLDGS.
New construction, single famil
VAR.*
C.U.P.+
DATE
APPROVED
detached, Plan 5, 5 Bedroomis.
APPRO
/D X20-7'7
OLD FOR SPECIAL
REQIJIF?F:A 4.F
1 hereby acknowledge that I have read this application and state
that the above Information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workmen's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are In full force and effect, or 1
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9,
VALUATION
PERMIT FEE E
PLAN CHECK E JV
Signature of
TAX E 1tS
v
Permittee
G V
$7°Q 10
Authorize
TOTAL PAID E
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