HomeMy WebLinkAbout850 CENTER ST - Building Permits,, , . _. APOlicant to fill in all spaces except those within M1eavy po�Oe� lines antl sign all aDP�aPriate tleclarationz.
� C�ITi�:AF COSTA MESA CONS�{� CTIOI�IP�RMIT � PE T N TRACT NO. ' LOT NO. 'UNIT NO. � ' EI 3B 9/28/B% '
T S7 � �o�sa - �5050
. Frojecf Address � �
AppliwnYs MailQ'ny�Add/�r�/$ ��J�JQJp��� � p TYPE OF CONSTRUCTION .rvew, ADo ER iOrv EVAiR
�• Owner'sName/_J�V^�� �� 7hnn,c/�I�Q �CONVERSION ❑DEMOLISH ❑ ER ��' p,p„# _ ' Zone
���.� '/ DESCRI IONO ORK/USEOFBLDG
Address �`lj�t% �Ir�"— �v � 3 L — �' E Main Building: ' Accessory Building: Z
ArChlEng. LiCenSe NO. TYPE OF PERMIT GRADING FOVNDATION STRUCTURAL T Front . ' p
Add�¢55 ' ❑ TENANT ❑ E TRIC ❑ PLUMBING ❑ MECHANICAL A Rear � . N
/ y��� ❑ OTHER
ConVactor's Nam'7 Phon¢P��4.L_�� � � ' C Right N
I, Address Im '1' gU%�% �L�fV� �2' � �� PROJECT DESCRIPTION SQ. FT. OCCUPANCv— ��
CONSTRUCTIONTVPE VALUATION$ Q�� � $ Left G
� Ciry�icenseNo. O���Z� ZONE GRADINGCU.VOS. ACRES — R
h LICENSED CONTRACTOR DECLARATION Ping. Ref.�# Pafking Req./P�ovided E
y ' I h¢reb atfl�m that I am lic¢nsetl untler rovi5ion5 0/ Charte� 9 commencin ' . � � �
Y P ( 9 Remarks: Planning Notes: M
witn section 7000) ot Division 3 of the Busine55 antl Protessions Cotle, antl T
my license is in full to na etfect. .
�lcen5¢ CId55 ¢OS¢ N � � S
Dat�'!� Sgnature � PLUMBING . FEES -
�WORKERS' COMPENSATION DE RATION Bdr Sink ShOwerS ' ELECTRICAL FEES
I hereby affirm that 1 have a certificale of con5ent to selt-in5u�e or a Cer[iticate
of Wo�ke�s' Compensation Insu�ance, or d certifietl coOY tne�eof (SeCtion gackflow Preventer S¢rviC¢ $ink •
3800, Lab. c) ' Automatic Washer Transformer ❑ 15-50 KW
, Policy No. ��� 2 Compan Backflow Irrigation Sewer Cap Construction Pole Sub. ' ' ❑ 50+ KW
; 0. Certifietl copy is hereby fumishetl. . ,
fJS�C �fi y is tiled with the city tling ' ion. Bathtubs Sewer Connection Cooking Unit � Meter ❑up to 100 amps
, �ate�^� Applicant . .
EXEMPTION FROM WORKERS' CO ENSATION OEC ATION Clarifiefs Solar Collecto�s DiShwasher Mete� ❑over 100 amp5 .
' (This z¢ction need not be mmplete0 i� the p¢rMit I5 for One huntlretl ($100) or
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric - Sub Panel
I cerlify that in the performance of the wo�k for which this permk is IssueQ I .
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors �0-1 HP �1 �- B � '
Workers' Compensation Laws of Californla.
Date Si9nature Floor Drains Swimming Pool w/Spa F.A.U. InaSolar �9-15 HP �76-15+ .
NOTICE: It, a1[e� making this tlecla�ation, you ShoWtl berome subject to tha
Workers' Compensa[ion provisions of the Labor Cotle, you must forthwith Floor Sinks Urinal Fixtu�es Microwave
comply with such p�ovisions or this pe�Tlt snall be tleemetl �evoketl.
CONSTRUCTION LENDING HGENCV GaSService OUtletS WaterCloSet . DeviCe8oxe5 '
1 hereby affirm that'there is a mnstruction lentling agency for the perfo�mance P012 Light �
of tM1e wo�k, for Iwhich this i e�mit i� ssuetl (Section 3097 Civ. C.) Interceptors Wdt¢/ H¢dt¢I OUtI¢IS Rd�g2
Lentler's Name �� �
Lentler's Atltlress �' I�Y �%/w�� Kitchen Sink - Water Service Switches ' Sign ' ' -
OWNER BUILDER �ECLARTLTION
' I hereby affllm that� I am exempt ffom the Contlactor's Li[ense Law fo� the L3v3tOfi¢5 AutO-WdSh Gdfbd 2 Di5 0531
followinq reason (Section �031.5 Business antl Protessional Cotle: Any city or 9 P Standing Sections
county whicn requires a permit to consfruct, alter, improve, Cemolisn os repav P—Trap Laundry Troys Generator �0-5 KW �5-15 KW �
any 5[ructu�e, p�ior to Its issuanc¢, also �equires the applicant fo� such permit Trash Compactor
to tile a signetl statement that he/she is liceqsetl pursuant to the provisions of ROOf D�ainS �
the Coniracror's License �aw (Chapter 9(corqmencing with Section 7000) of
Division 3 ot the Business antl Profe55ion5 CotleJ or that he/she is exempt
� therefrom an0 the basis fo�-the alleqetl exerryption. Any violation of Se[fiOn
7031.5 by any applicant for a permit subjects tne applicant to a civil
�enalty of not more than live huntlretl tlollars (y500).
I, as owner of the property or my employees with wages as their sole Reinspettion Fee $15 , ISSue Fee $ 3 .
compensalion, will tlo the work, antl the strUcture is not intendetl or oiferetl Reinspection Fee $15 Issue Fee $.3
, for sale (Section 7044, eusiness antl Professional Cotle: The Contractor's MECHANICAL FEES
LicenSe Law tloes not applY to an owner of a property who builtls or improves
thereon, antl who aoes such work himself/M1erseli or throu9h nis or her own goiler Hood or T e I ❑ � DEVELOPMENT SERVICES REQUIREMENTS: , -
emoloyees, oroviaetl that such improvementE are not intentletl or offeretl tor YP � ' Za�ipg qpproved By Date '
sdle. If, however, the builtling or improvemery� Is soltl within one year ot mm- Canopy Type II ❑
pletlon, the owner will have the burtlen o� provin9 ne/she tlltl not builtl or im- Duct - Under Ground Building Approved 6y Date
� ' prova to� the purpose of sale). .
❑ I, as owner ot the property, am exclusively conVacting wlth lioensetl con- Duct-StruCtural Refrigeration System AppliWtion luuad By Dat �
LIdCL06L0 COOS�fUCi ihE pIOjECi ($2CilOI1 IO44� BOSIOE55 dOtl PIOf25510115 COGB: F�
, The Contractor'S License Law tloes not appty to an owner ot property who Duct - Ventilating ' ❑0-700,000 BTU ❑100,000 BTU , $U ARV OfqFEES . O
builtls av improves Ihereon, anE who contra��s fo� such projects witn a con-
tractor(sf ucense pursuanhm tne Cantractors License Law). I am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteretion BUILDING PEflMiT $ �J � SMIP $ �
proof of their Worker's Compensation insurance snould be provitletl to me. . PLAN CHECK $ PERMIT
❑ 1 am exempt.untler Section B. & P. C. for this reason Firepl/Fact. Blt. ICBO # Fire Dampers PLUMBING $ ISSUANCE $
Date � Owner Heating System & Ducting Registers .
PLAN CHECK 25% $ ENERGV P.C. $
� I hereby certity that i have reatl mis appiication ana state that the aCove ❑0.700,000 BTU 0100,OOOBT ELECTRICAL $ GRADING $
iniormation is wrrecL I agree to comply with all city antl county ordinances ' •
ana state laws r9�ating to ilaing c s ion ntl h by authorize repre- PLAN CHECK 50% $ MICROFILM $
5¢ntative5 of R'k ciry enter the - entionetl property for �l'• �T
insPeclion 0 P es. - � /\ \/ J
. Signature .oate 9�tfFk7 . MECHANICAL $ TOTALFEE $
-�--�-
Drivers' Li or�55 � Reinspection Fee $15 Issue Fee � $ 3 PLAN CHECK 25% $ ,
CMF 0865-46, ev. SO/84' White - Builtlinq; Caqary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
CONSTRUCTION AND PLANNING , POOI & SPA
�APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Sail 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 UFER Gmd. 57. APPROVAL TO COVER-GUNITE
I 7. Footings �� � 58. Electrical Conduit-Undrgrnd.
8. Foundation �. 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Und�grnd. 60. Backwash Lines,P-Trap, O Undrgrnd.
10. Structural Floor Sy�Yerr4 61. APPROVAL TO DECK
� ,
11 . Property Sewer Line �& House Connection 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 Electrical-Conduit _ 66. Solar System�Final
16. Rough Elearic Wiring 67. Fencing & Access Approval .
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �t
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL ��! ;� r
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � � ..�'-'
.? '.".'�:!� ��''�
20. Rough Factory Fireplace APPROVALS Permit# _ �.
�.J:� I:
21. Ducts, in Structure 70. Underground Hydra � �•, �,.
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil �✓ i�:t
23. Gas Pipe-Rough & Test 72. Underground Flush � �,%. ��
24. Roof Framing 73. Undergrnd. Storage Tank O GaS ❑ Ojl� �' �� ,;�
25. Roof Sheathing 74. Overhead Hydro � �r��! 7
� �
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical �S
i
27. Frame and Flashing 76. Dry Standpipe "rJ ( �.%
28. Lathing & Siding � 77. FIXED SYSTEM FINAL C' v.,
29. Insulation ' 78. FIRE PREV. FINAL � ' f
30. Drywall�Nailing HEALTH DEPT. REQUIREMENY t� ��
31. Plaster'8rown Coat 79. FINAL INSPECTION �� �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � -
G„
33. Final Electric Notes: � �,, '�
34. Final Heatirig & Air Conditioning ��^ �!"
i'
35. Final Gas Pipe-Test � ('� �
36! Hood or Canopy � I�i�� ,f. �% ,`�''%
37,:j Final Factory Fireplace Z��� �� p; : j {',� `, {
3 .� Final Plumbing � �i�� �' �� ��� �'
39� Water Service-Final :1•',/ i � � � �` �'r , _
�i ,� s ,v
40. Gas Service-Final � �" y� t,�1�' I.. �'% �
.j
41. $olar pomesticFinal /'%1 `t ,/ _ ,'.� ,ti�
:.v .=�',� i' .r.
"'�4� 'Backflow Preventer �� ("� �.��'. � �1 /:l
�.7i N i� '� :S . ,r .
(�4�. Backflowlrrigation i� �%;� I, �+(i,. %;� •/!� �
':�Vi 'i
4
4.,4�'. /iandsca e Irri. ation S stem " � ` �y � �, V ` �i� � /, ' �
: S! P 9 Y �.;�j./ / .y : i .., .�
u ��
�l�5�Sound Attenuation - '' . i`j✓!%'� �� �.''r�"..
J46.;I�Bndicap Regulations � �� � f � , j �/` ^� v
4�. FINAL STRUCTURE & BUILDING �ry � . f �:'� r'! A�� �! ' ��r
���Special Requirements Completed ' ;;.J �. � `." '' i/ "' .
� ��
"49�ElectricReleasetoEdison r,� ��r i;�7 • '
t-;
50. Gas Release to Southern California Gas Co � ; � �� / �,
51. CERTIFICATE OF OCCUPANCY � �i ` -
No. Date .
. ADY�iwnt ta flll In all spaees exeaD� t�ase wit�in �aary DorAsr Iines anG tlgn all a�P�oorlata Eaclantlons.
� � GTY OF�COSTA MESA , . ' ' pE MiT NO. TRACT NO. ' LOT O. B . . � � � '
�CONSTRUCTIONPERMIT �- �� --]�ZS q� � It]75 6/23/Ei3 IHSoJa T(
AppliCenYS Msiling A ezs TYPE OF CONSTRUCTION NEW ADO . ALTERATION REPAIH , ' ' � �
, PfajeCtAddr ❑ CONVERSION ❑ DEMOLISH ❑ OTNER-� � � . � �
OWner'3 N e ` ho e D RIPTION OF WORK c6"'7CT• dLT. . G I�J E
S�� tn✓ ��r�t-�r�+ , ow p rri � E �
Addfess TVPE OF PERMI7 GRADING FOUNDATION- STRUCTURAL A. P.9W . ZONE
AfChlEng. ' �• �� , licBnSB NO. ❑ TENANT �ELECTRICAL PLUMBINQ ❑ MECHANICAL PLNG. REF. gW ' ' BUILDING '
❑ �OTMER REAR VARD (TO P/L)
Addfess ' -. . ' TO BUILDING
Contractor'sNema ����-"���� �oho�e�� �RQIECTDESCRIPTION SQ.FT.� '_pGCUVA v P INE
CONSTRUCTIONTVPF � VALUATIONS�.�a� _� �EFTSIDEVARD RIGHTSIDEVARD • '
Address (mailing) . . ' �
� ' � - ZON$ OHADIN6 CV.VDS. ACRFc PKG.SPACE REQ. PROVIDED -
Licanm No. -
UCENSED CONTRACTOH DECLAHATION � Ramarkf: �•' STREET WIDTM , PARK FEE.$ '
1 hereby alfl�m that 1 am U�enmtl unGer O�ovlslons of C�arte� 9(commencing - . ,
w1t11 SBttlon 7000) of DW�zlon 3 0} tlle Buslness antl ProfeSSlons CoEe, anC ' '' . SPECIAL CONDITIONS: ' - �
my Iltense IS In full force a0tl elfett. � �' .
LJcenze Class ucense No. PLUMBING. � � � � '
Data SlgAatufe
WORKERS'COMPENSATIONDECLARATION ' BafSink SBNerCep ELECTRICAL
1 hareoy alfirm tnat I nave a certlilwta of conunt to selMnsme or a certlflwte • Automatic Washer ' �Meter ❑over t0U amps
ot N/orkers' Compensatlon ��surance, or a cerUfied copy tneroof- (Sectlon �ackflow PreVenter $BN4riConntttion � - . - --
�~ .r Construction Pole� Sub Panel
3800, Lab. C.) ' � � Backflowlrrigation Solar.Collectors: . y� � ��
PoIIcy No. ComDany '" � - � � -� - - ~ ' � Cooking Unit � Sub Pole '
eCertNlaG<opYiiherebyfurnls�etl. =�88thtubs $Olat•Piping � �� '/ �0 a . - • � ,.: �
Certlfiatl cooY is Blatl with t�e clty,Bulitling Divislon. .(,yerifiers . 'Solar Tank ' .- ' � �� Dishwasher .� Motors 00.1 HP ❑ 1 h$
Dale � ' ADPllcant �
EXEMVTION FROM WORKERS' COMPENSATION OECIARATION Dl5hwe5ti2f SWimRlin POOI�W/Spe Dry2r5 ❑G85 � �ElEctriC InC.Solar �9-15 HP �16-15+
, �T�IssectiOn neeO not Oe tompleletl If tha permit Is far one hUn C(5300) or . _ 9 �'
iecertlfy tnat In the performan o e w ch i er ' t Is IssueE Drinking Fountains .�Urinal " �� ��/• ` y. "' _„ - Fan e;,;� . Micrawave - . -
' F.A.U. ,Pole Li ht � ' �
shalP not amploy any parsoo �n an ann r e e D)e<t to e' y�/eter Closet,"� �
worke ,fbllmer�ation Laws oi Cail rnla Flaor Drains � � i 9 �
Date � O u u L� � $ignatura ' � - - �
NOTICE: I(, after makiri9 this Ee<laratlon, you shou become sub7act m tne ' -- Floor Sinks � � : ' Water HeateS ,,� " Pixtures _ Range ' � _ �
Workars' Compensatlon provisions of lha Labor Cotle,.you must.forthwlth DeviceBox2s
compry with Suth Orovl5�an5 or this permit�5hal1 ba tleemeC r8voke0: GaSServiCe 'Ou[let5- WB12f$ErviCe ' - n Sign� � �
CONSTRUCTION�LEND�NG AOENCV ' ' ' � - Out18t5 . "
I haretiy affirm tha[ [�x e is a constCuct'i�on lentling agency for tha parformance • IntErceptOrS � - � � • . Standing SeCtionS O
of Ihe work Tor ,fm h this, pe�m�, is �<.��¢p (Sac1I n gp 97 Civ. CJ .
Lantler•s- rvame � ` � ti"�'� ^^��^- t�k�"`� `� �!,v _ � . Kifchen Sink ' • Switches` Trash Compactor � � O
Lentler's Atltlreu ' � S'�' �ti - . . '
OWNER BUILDER OECLARATION ' ` � ' LeVetof185 . . - ,` 6 ' 1 Garbage Dispoml , �
I hereby affirm that 1 am BxempF Trom the ContraUor'i ucense l.aw lor the , ; P_T �e �- . . �'` Generator.�0-5 KW 0545 KW � �
tollowing reason'(Sactlom 7031:5 Builnass antl Profasslonal Cotle: Any Nty or P' • � • ' '" y..�
county whlcn reqNres a Dermit to construct, aiter Imvrove, aemolisn�or reDalr . -, '� Transfarmer �15�50 KW '
any structura; prlor to its,issuance, also requires t{�e,aDD��<ant (or 5uc� permit Roof D�eins - � '� �' � .. �
to file a signe0 ztatament that ne/i�e I5 Iltensetl pur5uant to the provisions of � 05U+ KW �
� the Contrattor's License Law (Chapter 9 (commencin9 wlth'Soctlon 7000) of ' � , � � ' ' _ ' � � „ ''' I Reinspeetion Fee ,
D Islon 3 of t�e.Buziness antl Professlons COUe) br that he/s�e�is exempt Show8�5 . � - � , Reinspectian Fee i �$ . ' _ . ,
e/rom antl the; basis for the alle9e0 axemption. Any.vlolatlon� oi�SacNon �. - , , - ' ' ' ��• Meter ❑up to 700ampi ;�saue Fee ' '$ 3
1.5 by•any dOD�iwnt fOr a'permit SUDjectS tha applicant t0 d; civll "• �" � . �' Y .
alty of not more enan iive nunaretl tlollars (SSooj: 1� -' �� Service Sink ' ; Issue Fee '- y,S 3'1 � Zo�i�B.qpP�oved By Date
I,'as owner of� the prOPerty ormy employees �wlth wages as their iole � .s, 'J.. ,� .
compensatlon wilLtlo the work, antl the,structure'is not IntentleA orofieretl - � � - MECHANICAL � i� � qpp���tionfApprored By ate
tor sale (5ecflon 7oaa', Businesr antl aroreutonal Cotle: 7he Contrattor•s � ' � � . � ;
Ucense Lnw Ooes not apply to�an ownor o1 a property who builtls or improws � goiler � Refrigeration System � ' �
thereon,�an0 who'Coa suGh work hirtisalt/herself or t�rougM1 his or her own ' Applimtion Issuad By � Date
employeas, proWCetl tnat sucn ImDrovements are not Intentletl or o/fereG for : ' Duct- UnderGround ❑0.100,OOOBTU ❑100,OOOBTU ,��
e. If, nowemr, the builtling or improvement is soltl witnin one year ot com- . - � -• ��, .� UMMARV OF fEES
Ion, t�e owner'will nave tha burtlan ot proving he/she Altl nol buib or Im- � 'i ' / �-y
ve (or tha ur ose of sale � ' � ' � � � Duct - SVuctural , S stem Re air/Alteration ' . � 1 ' p ' ��.1 � '
? o �� � � P BUILDING PERMIT S� � SMIP $�
I, as owner o/ tha prop¢rty, am axtlusively contracHng wlth,licanzetl con- - , ! /�/� �� . �
ttorsto mnstruct the prolect (Section 7044,.Businasz antl Professionz Cotla: _ . Duct- VOntilating _ � � _ _ �;; � '� �PLAN CHECK � $ �aiLf � PERMIT ' �� �
The Con[ractor's Gcense t-a`�' does not aOPly to an owner of Property who ( y � � � ISSUANCE � '$' �
bulltls or Improves thereon, antl who contra<ts tor tuch pro)ects wi[h a com Exhaust System O Multiple 0� 1 ' j� � '�PLUMBING ' $�� �00 � , , �
tractor(s) Iicense pursuant to the Contractor s Litense law): � '��' � '� /^ f� ' � I GRADING �$ i
' ' ' � 'i PLAN CHECK $ �
❑ I am enempt unOer Section ', � B. 6 7. C. tor this reason ' Firepl/PeCt. Blt. ICBO i� � . . � • �
Date � � ' Owner • ' � Heating System & Ducting ' � . , � � ELECTRICAL $ � ' ' ' ' $ ' -
� �I-'�ereby -cerHfy tn 1 na+e-reatl t� app�icatlo riG state that tne�a�ove � �4100,000 BTU �100,000 � , ' PLAN CHECK � $ 0. � MICROFILM .'$ '
Informatlon ec t agree co y with all It an county ortlinances � I ! � - • TOTAL FEE' $
antl ws re a c truction, ntl h by aulhorize repre- Hood or T e I � MECHANICAL $ ,
' sentativai f-lhis � o �t r up the ab ve-men onetl rty br � �P � ' Reins 6ction Fee � �$15 � LESS '
Inspaction urp et � ��NL e1 . Ceno T e II ❑ P . PLAN CHECK� , $ ' � qDVANCED PC �$� •
Signature � ata J � ' • .
Registers ' , Isiue Fee S 3 ��!� QA
Drivarz• Licansa or�55 � ' ' � FINAL FEE $�__�_�._,_y�,
CMF 0865-46 rev, 12/82 Whlta - BUIIEIng; Canary - ApP���n[: Plnk - Accounting; Goltlenrotl - Assassor � • �
�
, , ' .. -,.. . r. i . , . ,. ... , . . . . .. . r-. .. . . +
I �
18091
CO�TA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIRORNIA
For Applieanf fo Fill In Complefely
TYPE OR PRINT
aooRe�ss 850 Center Street A,B�C�D
COSTA MESA CALIFORNIA
OWNER Dillman & Bxvmmell Enterprises
MAIL 1322 E. Ocean �`ront
ADDRE55
c�TM Balboa Noor31807
ORCENGI EER W.T. Jordan NpL�S7�.51
ADDRESS 771 w. 1J�h `St. COS't8 Mesa
CONTRACTOR �er-Bldr. �
ADDRESS
-------
arr'--"---
STATE ������� _ TEL. -�---
LIC. NO. 1. NO.
61ZE 1z�� X 42�� I NO. OP BLDOO��
O.
OF LOT Now ON LOT
USE OF � �_
EXISTING BLDG
BHTBACK LIN6 PROM qO� �51
CeNTeR OF BTREBT l REAR YARD
� 8' � 8'
SI�E YARD LEFT RIGMT
DESCRIPTION OF WORK
_._... I x II .. ___._._.. I II •--•-.--. I
2
NALL,tuCCO I COVERING ROCiS
S
ILDING AND WORK TO BE PERFOR�
1 HER¢BY AGKNOWlPD06 TXAT 1 HAVB READ THI9 MPLIGTION
I.N� 9TAT¢ THAT TH6 ABO IB CORRBC} AND AGR86 TO COM-
PLY WITH ALL CITY O �/�ND TH LAW9 R86ULATINO
OUILDINO CONBTRU
BIGNATURE OP / - ��� J
� AUTHORIZED AGENT
�rEE ��C���l��
� NOV 1 �gg2
, / FINF,iNCE DEPT.
CIIY OF COSTA h9ESA
APPLICATION FOR PERMIT
BUILDING
For O#iee Use Only
��� , a. I o. � 3�6
� �
BUILDING �D
ADDRESB /��
cosra mesa cwuFc
FIRE
ZONE NPE G
APPROVED
BY OATF
ZONING
ZONE ,r NO. OF U8E OP �
R� Y. I PUN9 Z Bl1�lD�NO
LHOAL �P,�. u�p 7-�
DEeGRIPTION
A.P.NO. '��,— �3� -33
YARDS EVES
APPROVED ALLO EC
�ceNrex uNe BTJ���
1
BYPROVED� ` DATE La','Y_6 z,
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TN6 AMOUNT BXOWN UND¢R VALUATION 19 ROq TN8 (�J
PURPOBE Op, EBTABLIBHIN6 A PERMIT FEE ONLY. (L
VALUATION �
PERMI7 FEE $ ��� �'— a
� ��Sd— / " �
S f PLAN CHECK S Sh �S� 0
'SG � �
TOTAL FEE n d
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a issoi
C�STA MESA BUILDING-SAPEfY DEPARTMENT
P.O.BO1[81] C09TA M6BA.CALIFORNIA
For qppliconf �o Fill In Complefely
TYPE OR PRINT
■ ARGH17EC7
■ STATE
COSTA MESA. CALIFORNIA
f I rvO.oP
DESCRIPTION OF WORK
WALL
�
1 HEREBY ACKNOWLHO08 THAT � HAVB qBAO TMI9 �PP�IGTION
AND STATH THAT }ryH ABOV6 18 COqpECT ANG AOREH TO COM.
PLY WITH ALL CITY OROINANCEB ANO 6TAT8 LAWB P@OYLATINO
BUILGINO CONBTqUR10N.
SIGNATUREO����� t � �/ r-
PERMITTEF f /�J�lis IC�J�/EsC%�
AUTHORIZED AGENT �N `-l�Sil�1TDa�"•�
F .E RECEIVED
fEd z 0 1963
FINANCE DEPT.
For Office Use Only
LEOAL
VARDSAPPROVED
MAIN BUILDING
(FROM C/LSTREET)
VAR. Yi
x�cervao
u
ZONING
n use
.T aun
3%-33
8HALL 9E LE55 THAN
YAROSAPPROVED
ACGESSORYHUILDIN6
DATE
s'
� L �.l 8�. FT. ^
' T118 �MOUNT 6HOWry UNOOP VALUATION 19 POH THE _
PURPOB6 OP 68T/�BLI9HINO • PERMIT FEfi ONLY. �
VALUATION m
$����--) P2RMITFEB $ '� ¢
m
q��/I o
�..�.. .��� c ��J�.�Cl� LL
c
aooeess: g50 CENTER ST
rsxnme:ANDERSON CONNIE
aooxess:177.20 NE�THOPE ST li224
FOUNTAIN VALLEY,CA 92708
pODNE55:
flEG.NO.:
uxir: CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 061137 PLAN CHECK NO: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR
I1NIT:
PEPMITTEE: MCCAHE DEVELOPMENi, INC. ( 714 ) 540-2698
ADOflE55:1'�2(O NEWHOPE
FOUNTAIN VALLEY CA 92708
UCENSEO CONTHACTOfl UECIAPATION: I hereby aRirm I�a� I am licensetl untler O�ovisions oi C�ap�er 9(commencing wi[h Seclion
7000) ol Dimsion 3 ollhe Business and Pm�esSions Cotle. antl my Iicense is in �ullforce antl eftect.
ciTvuc.^:0��—jj/.. 3.�6.�0r$�� srareuc.566954 cuss:g �!
Date: —�.�(�1�.— Signature: „e�� /��S
WOflREBS' COMPENSATION UECNPPTION: I hereby aflirm Iha� I have a ceriific�� �o selbinsure or a cenifica�e of Workers'
ComOensalion Insurance, ar a certifie0 capy Ihereoi (Seqion 3800. Lah. C
voucreo.:1105862-97. E%P.DFTE:1 IOS�93
comraxv:ST6ATE FUND
❑ Cetli�i¢tl topY is here�y �umi5Ae0. B� Certitietl copY is file0 wi�h t�e ciry BuilA' g Division.
al��l�� ` �j�
�ate: Applican�: T��
EXEMPTIONFflOMWOPREPS'COMPENSATION�ECIABRTION: Qhissec�ianneeanOtDetOmple�etliltheDermi�i5foronehunEred�$100�orIe55�.
I cerli�y Inal in Ihe petlormance oi lne work lor which this permit is i55ue41 shall no� employ any De�son in any manner so as �o become
sublect lo ��e Workers Compensa�ion laws al Califomia
�ale'. Signa�ure:
NOTICE: I�, afler making this declaration. you s�ould become sublect lo �he Workers' Campensation pmvisions of ��e Labar
Cotle, you mu5i fo�hwilA comply wilh such pmvisions or �his permil s�all be tleemed revoke0.
CONSTPUC110N LENDING AGENCY: I here�y affirm that �here is a cons�mction lending agenry �or IAe De�ormance ot �he wark �or
w�ich Ihis permil is fssuetl �Section 3W7. Civ. C�.
LENDEfl:
noowess:
JOB DESCRIPTION ; T/O REROOF W/3 PLY HOT MOP
CLAIM VALUE
PERM NO: B 061137
GOVT; N SUPP; N
PURPOSE: ALT
SQ FT: 5,500
5,500.00 CALC—VALUE: 5,500,00 GROUP OCC; R-1 /
COMMENTS; SMOKE DETECTORS RE�UIRED REROOF 2500SF 9—UNIT APARTMENT R
iEiPiEiFiF1EiE3EiE3FiPiEitiEilifiFiE3EiEifiElEiEi6lfikiE iEX-iEiE�EiE�EiEiE�fif*ikiEiEifiE3EiEiFiFifiElEiF3f3E1E3F34�1lif3EiF�%�1E'.E�f�F3F* .`�i'rX�'%�1 '
2 O N I N GS ERTEBQAUCIxRSE M E N T S S�OKE D� � c�
------------ MAIN BUILDING ---------- --------- ACCESSORY BUI��U�R�� -
FRNT: 1�'T IN REAR: FT IN F'RNT: FT IN REAR: F'T IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ • PROV; PARCEL; 42419118 ZNE; REF NO;
PLANNING NtSTES>
> �
iF iE if i(� �lE ik 3t if ik iE iF if 1E 9E 1f��if IE ih iE iE ik !E iE iE iF iE if iE if # if if if iE il-iF lf �1(-iF 1E if iE iElE iE �7E iE if ih iE !E iE iE iE iF 1E iE iE 3E 1E lf iE �lElF 1E 1E iE if iE iE iP'if iF 1f if �E lE )E iE
D E V E:L O P M E N T S E R V Z C E 5 R E Q U I R E M E N T S
� . .
ZONING APPROVED HY PATE;, '
�.
i•III�iR����fh
m
DATE:
APPLICATION ISSUED BY: �� AATE: 2- ��
iEkiElEiEiEiE�IEiElEIE1Eit7Eitiflf-1EiEiElEiFiFiF3fiFiFiFiFiF7FiFiEiFfE�F�F�if�F7i��FiF 3F3t3F3F�3F3FiF%'iFiFiEif3f14ifiFiPiElf�aE 1EiE
iE 1E if 3f iE iE it iE iE iE iElf � it 1E �E IE fF iE 3E 3E iE if iF iE iE iE k jF jF iE �! iE iE iE iE iE iE itlE iE iF iE iE iE �EiE 1E if ik if �f iE iF if 3E iE iE iE IE k 1t 1F iF IE 1E 3f iE 3E iE iE �E K� iE iE iF iE #?E
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
owNExeuuoexoeciAHAnox: inerebyaifirmihatiame.emptimmtnecamracars'statelicense�awiorinerouowingreason BLDG PMT PLUMBING ELECTRSC MECHANIC FIRE SMIP/RBS GRADING
(Section 7031.5 Business antl Prolessional CoOe: Any ciry of couniy which requires a permi� ta cons�mct, al�er, impmve, tlemolish, ar pERM 2 T 81 , � � .� . 5 5
repair any slmciure, prior �o i�s issuance, also requires the applicant �ar such pe�mi� �o �ile a signetl s�a�ement Iha� he/she is licensed �. � SMIP /NON—RES
pursuam to �he pmvisions af the Conlrac�oK State License Law (ChaD�er 9(commencing wiih Sec�ion 7000) o� Divisian 3 0� [he Business � '
anA �ro�essians Code) or lha� he/she is ecempt therefrom and Ihe �asis lor ��e allegetl exemption. Any viola�ion oi Sec�ion 7031.5 by pL� .
any applicant for a Dermi� subjec�s ��e aDPlicant lo a civil penalry o� noi more Ihan five huntlred dollars (5500). I$S(]E FEE `
�, as owner o� �he pwpeny or my emp�oyees with wages as ineir so�e compensaiion. will tlo ihe wark, and Ne BUILDING—DIV—> PERMI� IS$UE P7�AN1iCHECK TOTAL PAID DTJE
❑ simcmre is not inten0etl or ollereU lor ule (Section 7044, Business an0 Pmfessional Cotle: The Contractors' S�a�e License Law TOTALS ----> 81 , rJ .J �, 0 � �� .. �. � 0 81. 5 5 81 , rJ S , � �
does nal apply Io an owner ol a properiy who Oui105 or Impmves Ihereon, an0 who does suc� work himsell/�ersetf or lhmugh ��
�is or her own employees, O�ovitlea �hat 5uch improvements are not intendetl or oneretl �or sale. I�, howeve� the buiitling or REVENUE DI V I S ION TOTALS--> COLLECTED ; B 1. 55 OVER /SHOitT • Q �
. impmvemen� is sald wiihin one year o� compleiion, Ihe owner will �ave ��e burden of pwving he/she diJ nol 6ui10 or impmve
rormeourPoseo�sa�e�. HLDG PMT PLOMBING EL$CTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner ot the pmperty. am exclusively con�racting wiih licensed coniractors �o conslmc� lhe prole�� (Sec�ion 7044, Busine5s 8 1, Q Q ��� . 5 J
❑ and Pwlessions Coae: ihe Contrac�ors' S�a�e LicenSe Law Ooes not apply Io an owner of pmpehy who builds or impmves �hereon '
' andwhocon�radsforsuc�proleclswi�haconVactor�s)Iicensepursuam�o�heCantrac�ors'S�a�eLicenseLaw).lamaware {E**iE3E3F*3kiF3f�ffEiE{kjFj(�IFiEiEifiE1ElEiF3FiEiF7fif1F�IEifffiE.1E"IFffiEiklkifiE3EiE3E3EiEiEiEiE1E3FiE3F-%fki4iEjE343E1EiFiEiFlEiE3E3fiE3EiF1F3E3E1Fif3Elf�
tha� pmol of �heir Worker's Compensation insurance shoulU be Drovitletl m me. I N D I �7 j D U A'L - -F�:E E B R E A}C D O W I�
� I am exempt untler Seclion: B. 8 P. C. �
mrmisreason: TYPE QTY D E S C R I P T I O N� r UNZT COST TOTAL COST
Oale: Owner:
I ao �ereby cetlily Iha� I am aware ol anA untlers�and Ihe requiremen�s o� Calilomia Healih antl Satery CODe Sections 2550.5, 25533, antl
2553a anA Inat I or any future buil0ing occuDant willlwill not �circle one) neetl to comply with saitl state co�es anJ ihe requiremenis for a
permil �ar con5lruclion or moeihcation �mm Ihe Air Duahty Managemeni Dis�ricl. ResiAential con5�mciion applica�ions are exempt �mm
Ihese prouisions.
�aie: ApplicanC
I hereby certify I�at I �ave read �his applica�ion and sla�e tha� Ihe above inlorma�ion is correct I agree Io comply wi�� all ci�y antl counry
� ortlinances an0 s�a�elawsrelatingta buil0ing constmction and hereby aulhorizerepresen�atives otUis cityto enteruponlhe ahove�men�ione0
' pmpetly lor inspec�ion urpases.
� � Oa�e: �("1OL3�— SignaWre-
Oriver's License or Sociai Secuniy
' 16<1�46 W�i�e-0uiltling; Green—Cotle Enbrcement; Canary—Applicanl; Pink—Revenue: Goldenrad—Assessor
r
SFR 5500 REROOF BY VALUE RESIDENTI�AL NOZONE 1.00 5,500,00
END OF•`. FEES
i �.
�; �
� �
�
!
�CONt� RUCTION AND PL,ANNING ,. POOL & SPA �
APPRQVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1
1. Temporary Electrical Service pr Pole ! 52. Pool & Equipment Location �
2. Soil Pipe�Undrgrnd. ' 53. Steel Reinforcement �
. 3. Electricai Conduit Utility�Urjdrgrnd. 54. Forms
4. Electricel Conduit•Und;ymd. ' 55. Hectricai Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Etectrical UFEfl Grnd. 57. APPROVAL TO COVER�GUNiTE �
7. Footings 58. Electrical Conduii�Undrgrnd. �
8. Foundation �� � . 59. Gas Pipe, O Untlrgrnd., Test ♦!�
9. Water Pipe�Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. �^�
10. Structurai Floor System ,. � � 61. APPROVAL TO DECK � .
11. Property Sewer Line & House Co�nection ��� 62. Backwash & Receptor-Finai .• 1
72. Sewer Cap . I' 63. Heater & Vent-Final ��, !
13. Roof Orains _ �
} 6A. Ptumbing SYstem - Finat f
14. Rouoh Plumding � -� 65. Electrical�Final �
75. Rough Elect�ical-Condu�t 66. Solar SyStem�Pinal . �`
76. Rough Elect�ic Wiring 67. Fencing & Access Approval !
17. Rough Wiring Sign 68, APPROVED FOR PLASTERING !
,
18. Rough Electrical-T Bar Ceiling 69. POOI(SPA SYSiEMS FINAI �
�
19. Rough Heacing & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rough Facm�Y Fireplace APPROVALS Permit #�` �
�
21 . Ducts, in Structure 70. Underground Hydro �
22. Duc2s, Ventilating � . 71, Product Piping �Gas ❑Oii
� i
23. Gas Pipe-Rough & Tes[ � . 72. Underground Fiush
24. Roof Framing 73: Undergrnd. Storage Tank � Gas i� Qil f
25. Roof Sheathing 3/'l�3 �� 74. Overhead Hydro �
26. T-8ar Ceiling (Structurall & Monocoat 75. Dry Chemical (
27. Frame and Flashing 76. Dry Standpipe �
�
28. Lathing & Siding � 77. FIXED SYSTEM FINAL j
29. Insulation - � I � 78,� FIRE PREV. FINAL �
30. Drytvail Nailing . I � � NEA�TN pEPT. REQUIREMENT �
31. Plaster Brown Coat � � i � 7g. FINAL INSPECTION �
32. Electrical Power Meter-Final � � ' 80. FOOD CERTtFICATE ISSUED �
33. Final Electric � � � � tVotes:�� /� /�is�� L _ � _/1 I
cv� +aa ���-c- �ie,� =�
34, Fina4 HeaYing & Air Conditioning � � � �
l_�4.�_.�,'_w_- .
35. Finai Gas Pipe�Test � � � ' . ?���f.3�
36. Nood or Canopy �
I
37. Final FactoN Fireplace � ! � �__� _ij
38. Final Plumbing ' i �� � j
39. Wzter Service-Pinal ! I �
� 4
40. Gas Service-��nal 1 � i �
41. Solar pomesiic-Pina! j � �
, I
42. Backfiow Preventer I � I i
43. Backflow irrigation . �
44. tandscape Irriqation System
45. Sound Attenuation . j
46. Hardicap Regulations - .
47. FINAL STRUCTURE & BUJLDING � � � �
46. FINAL P�ANNING ' � �/ � 3 I .
49. Electric Release tofEdiso��_ ;
50. Gas Release to SoUihem Californla Gas Co I f. � �
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER
JOB AD
� DA'rE 11-30-62
d.��..-'. BUILDING PERr4IT NO.
GENERAL CONTRACTOR pymep VALUE S 3E3.; 850.00
AP No. 176-047-44 LOT TRACT FIRE ZONE DESCRIPTION OF R'ORK avt blda_
IN5PECTIONS
OCCUPANCY
�
DA1'E I GROUP ri TYPE V 7.ONE
v
%�
SUBCONTRACI'OR