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Home My WebLink About922 AZALEA DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 922 AZALEA DR Suite: Vicinity: RESIDENCE 8 ATTACHED GARAGE Parce� Number. 41221215 Applicant CARSON , MIKE Address: 1207 N CITRON LN ANAHEIM,CA Owner: DAY, ROBERT O Address 922 AZALEA DR Zoning: Rl R1 Phone: 714-635-4912 Zip: 92801 Phone: COSTA MESA, CA Zip'. 92626 Contrector: CARSON ROOFING AND INSPECTION Address: 1207 N CITRON LN ANAHEIM, CA Zip: 92801 Arch : Address: Phone: 714-635-0912 License: 661526 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: Ot126/2001 Issuetl� 01/26/2001 PhOne: Zip: License: License: SCOPE OF PERMIT REROOF: TIO EXISTING ROOF, 1/2" OSB, 1 LAYER 15# ASTM FELT, APPLY 25-YEAR ASPHALT COMP SHINGLES. 28$QUARES Pian Check. Permit: SMIP Res: SMIP Com: Other: Inspection: $0.00 $125.25 5�.55 $0.00 $0.00 $0.00 Total: $725.80 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING existin : 0 NOTES: Rear 0-0 Rear 0-0 Reouired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Va�uation: Claim Valuation: Righl 0- 0 Right 0- 0 ss,soo.00 ss,soo.00 I NOTICE: The work authorizetl by ihis permit shall comply with all applicable handicap access requiremen�s under Califomia statutes and related �� regulations. (Ord. No. 92-28, § 7, 12-21•92) � EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. IN5PECTIONS: In order for the work authorized under this permif co be considered legal, such work must comply with all applicable codes, end a11 requlred Inapectlona end flnel approval mus[ be obtainetl. Failure to obtain inspections antl Final approval will result in iha expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2aaW8(8�00) WORKERS' COMPENSAnON DECLAFiAnON: ' � I I hereby attirm under penally of peryury one o� the following declarations: ❑ I have entl will meintein e certificate ot consent to self-Insure for workers' compensetlon, es providetl tor by section 3700 af ihe Lebo� Code, tor the performence of the wark lor which this permil is issuetl. I ❑� 1 have endy�ill maintain workere' compe�selion insurenca, as requiretl by section 3700 of the Lebor Cotle, for the perfortnance of tha work tor which ihis pertnil is issuetl. My wod� (s' campensation Insurence cerder end policy number ere: I Cerrier: Policy Number: (This tion need not 6e complefed 1! the permif is va/uetl e( one huntlretl tlallers ($100) or Iess.J I I certity that in the peAortnance of the work for which this permit is Issued, I shell not employ eny person In eny manner so as lo become subject to the workers' compensation lews at Celllomla, entl e e Ihet If I shaultl becoma su6�ect to ihe workers' compensetion provlslons of Sectlon 3700 oi the Leboi Coda, I shall forihwith comply wiih �hese provislons. /' � � n/ I % Applicant SlgneWre: `�� Date: GY — �/ � WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEHAGE IS UNLAWFUL FND 511ALL SU&IEGT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED THOUSMID DOLLAFE (5100.000�, IN ADDITION TO1HE COST OF CAMPENSATION, DAMAGES AS PROVIDED FOF IN SECTION 31060F THE 1A90R CODE, INfEFEST, AND ATTORNEVS fEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm ihet 1 am licensed under vi � ns f aDlgr 9.fEommencing with Sectlon 7000) of Olvision 3 of ihe Business and tessia sppode, antl my license Is In full force end ettecL Lic. N �� 1�� Cless» � _/ �, Contractors Signemre: /1"�i� . Dete: f' � CONSTRUCTION LENDING AGENCV: ❑ I hereby aNirm ihal lhere is a construclion lending agency lor ihe performance of the work for which ihis permit Is issued. (Sec. 3097, Ciwl Lentler's Name: Signeture: _ Lendafs Adtlress: Dale: OWNER-BUILDER DECLARATIONS: I I hereby eHirm thel under penalty ol per�ury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Protesslons Cotle: Any ciry or counry which reQuires e petmi� to consiruct, elter, improve, tlemolish, or repalr any structure, pnor to its issuence, elso requires the applicant for such pertnit to file e slgned stetemeni thet he or she Is Ilcensed pursuent to ihe provislans ot ihe Contredors License Law (Chapter B(commencing wlih Sectlon 7000) ot Dlvlsion 3 af ihe Business and Protessions Cotle) or ihat he or sha is exempt therefrom antl Ihe basis lor Ihe elleged esemption. Any violetion of Sechon 7031.5 byi ny epplicent for e permit subjeMs the epplicant to e clvil penelry ot not more then five huntlretl tlollers (5500).): , ❑ I, as owner of the properry, or my employees with weges as their sole compensation, WILL DO THE WORK, antl tha structure Is not Inlendetl or offeretl for sale (Sec. 7044, Business antl Prolessions Code: The Contractors License Law tloes not apply to an owner of property who builtls or improves thereon, and who does such work himself or hersel( or lhrough his or her own employees, providetl thef such improvemenls are not intendad or ottered tor sele. If, however, ihe tiuilding or Improvement Is sold within one year of wmpletion, the Owner-builder will have ihe burden ot proving that he or she ditl not build or improve lor purpase ol sele.). ❑ I, as owner of ihe property, am E%CLUSIVELV CONTRACTING WI7}i LICENSED CON7RACTORS lo construct 1he project (Sec. 7044, Busiriess entl Professions Code: The con�ractors Llcense Law tloes nol epply to en owner of properry who builds or Improves thereon, entl who coniracts for such projecl wl�h e conirector(s) license pursuant lo the Contrectors License Laws.). ❑�I am ezempt under sec. Business and Professions Code for thls reeson: Signatura: Date: � Owner ID verilietl by tlrivers license. ❑ Yes ❑ No Orivers License No. Eipires: Verificetlon of Ownership by (type of tlocumeryt, i e. - properry tax bill or deed): � i DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: I ❑ I hereby certify ihat no excevetion five (5) or mora teet In depth Into which e person is requirad to tlescend, will be made in connection with work euthoMzed by t�is permiL end thet no building siructura, scaHolding, �alsework, or tlemolltion or tlismantling thereof, will be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tllle 8, Celifomia Adminisirative Cpde). ❑ As owner-builder, I wlll not employ anyprre to do worlc whlch would requlre e permit Irom the Division ot Industrie! Setery, as noted above,l unless Such person hes e permil to tlo such work from the divisio�. Sipnature: Date: Division of Industnal Safery Permil Number: I HAZARDOUS MATERIALS AND EMISSION6 CERTIFICATION: I 1 W ill �he epplicant o� present or future building occupent need to file end cer6ty e Business Plan for emergency response lo releese or threatalnetl release of e hezertlous meterlal7 ❑ Yes ❑ No (Section 25505 ot the Calitomia Heall� entl Sefery Cotle requlres, with some exceptions, ihet a Business Plen be filetl wi�h the Costa Mesa Fire Department Gy every business which has at any one time tlunng a reportetl year e quantiry of hazartlous materials equel to or greeter then e weight of 500 pountls, or e volume of 55 gallons, or 200 cubic feet of compressed gas at stendard temparacure and pressura). I r will ihe a licant or resent or 1 n�need to file e re istration torm for acutel �hazartlous materials7 Yes No ..... .. ................................. 2 Does o pp p Uture building acupe t g y ❑ I❑ (Sactlon 25533 of Ihe Celifomia Heellh and Safery CoOe, with some exceptlons, requires registratlon with Ihe Cwta Mesa Fire Deperiment by each business which at any one �ime hes on hentl a quentity of ecutely hazertlous meterlals equel to or greeter ihen e weight of 500 pounds, or e valume ol 55 gellons, or 200 cublc feet of compressed ges et stantlertl tempereWre and pressure). � ...................................... .. .............................................................................................................................................................. ................................................................................................................................................................................... 3 Does or will iha epplicant or present or l4ture bulltling occupent neetl lo prepare an RMPP (Rlsk Manegement and Prevention Program for ec i tely hazertlous melerlels)7 ❑ Ves ❑ No (Sectlon 25534 of the Califomie Heal�h end Sefety Code prowtles that Ihe Costa Mesa Fire Depenmenl may requlre ihe preparetlon, cerliticetion and tlling wi�h ihe Fire bepertmenl ot en RMPP by businesses which ere required io register acutely hezardous materlels with the Fire DeDertment. � ............................................................. ............................................................................................................................................................................... ................................................................................................ 4 If en RMPP is presently requiretl, has Section 25534 of the Celifornia Haalth end Safery Code been tully complied with7 ❑ Yes ❑ No � ..................................................................................................................................................................................................................... ...................................................................................................................................................................... 5 Does or wlll tha epplicent or present or future builtling occupant requlre lor lhe work which is the subject of ihis a plication e pertnit lor suchl consiruction or motlificetlon irom the Sauth Coast Alr Ouallry Management Disirlct or irom eny o�ner air pollution control disMct or egencyl � Ves u No (Section 65850 2 at ihe Califomie Govarnment Code requires ihat ihe requestetl Inlormation be furnishetl on epplications for non-residentiel building permits). 6 Will eny pert ot the taciliry to be construcletl untler ihis permil be within 1000 feet from ihe outer bounderles of e school7 ❑�Yes ❑ Na � (If "yes", the faciliry must meet the requirgment of Sections 25534 and 42303 of the Californie Health entl Safery Cotle). I ........................................................................................................................................................................................................................................................................................................................._............................................................... 7 II e pertnit from the South Goesl Air OUeliry Menegemant Distnct or other eir pollulion control distnct or agency Is requiretl for Ihe work which is the subject of ihls epplication, have ell of ihe disclosures prescribetl by Celilornla Heallh antl Salery Code Sectlon 42303 been matle7 ❑ Ves ❑ Na � ............................ .................................................................................................................................................................................................................................................................................................................................. 8 Qf'yes", altach certdicate of compllance from ihe eppropriate air pollution control oflicer). � CERTIFICATE OF COMPLIANCE: I ceRify Ihet untlar penalry of per�ury ihe informeuon given ebove is correct. 1 agree to comply wilh all si te lews antl city ordinances regarding Harardous Metenals and Emissions. Signeture: Dete: CERTIFlCATE OF COMPLAANCE AND AUiFiORIZATION OF ENTRY: I certify untler penalty of pe�ury that I have reetl lhis epplicaUon entl stete Ihet the infarmation given Is correcl. I agree to comply with all stete laws end city ortlinances rela�ing to bullding construction, antl aulhonze representatives of Ihe Clry af Costa Mesa to enter upon t�e above�tlescribed property for inspeclion purpOses. I egree not to occupy or ellow acupancy of eny building authorized by this pertnit unlil finel inspection. I S eWr LgpalOwner(s) �ate 'L—_ �� o% 1 AnNOr AUlhonzed Applicant Dete I � CQOE�. INSPEC�IONTYPE ' Qsjf, �$ y�fs INSPECTIONTYGE I Qe¢. f� 1816 Fizetl System Final Flre Preveniion 206 Final Mechenicel 1266 Pool Spe Final ��,� 4 208 Final Plumbing I 200 Finel Re-Roof �—�_� G W!� 210 Finel Electrical � 201 Fine181ocWRetaining Well 212 Final Fire Prevention � 202 Final Fectory Fire Place 220 Finel Planning Approvel � 203 Finel Sign 222 Final Sl�e I 204 Finel Demolition 250 Final Building/Occupency � I /F �� Applieant to fill in all spaces�within heavy boraer lines ana.sign all aOPropriale tleclarotions. ' CITY OF COSTA MESA PERMIT NO. TRAGT NO. LOT NO. �BLDG. NO. ,`2�jJI/ BIOrJ�BI (4p�JO CONSTRUCTION PERMIT fY�-fi$� Projet[ Address � r �, - � ,Z Lq,I eq, r, GS . tS0. TYPE OF CONSTRUCTION _ OWneI � Phone ❑ NEW '� ADD ❑ ALTERAT�ON Addre55 � 0. y-. � ❑REPAIR ❑CONVERSION ❑DEMOLISH � ' ZONING REGULATIONS Arch/Eng. � License No. ❑ �THER DESCRIPTION OF WORK a � P"P' � - Add�255 �ZONE PLNG. REF. $ Contractor - G Phone '�i Z-) �I � TVPE OF PERMIT �� BUEI IDING 'SETBACK L T. OP RTY LINE Addf2ss � �, � y , � . ❑ GRADING ❑ FOUNDATION ❑ STRUGTURAL SIOE VARD LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING �MECHANICA L5EDE V I hereby atlirm that 1 am licensetl untler provisions of Charter 9(com- . RIGHT mentln9 �+'�lh Sectlon 7000) of Dlvislon 3 0( the Busine55 antl ❑ OTHER Profazsions Catl antl my Ilcense is In fuli force antl e(fect.. REAR VARD (TO P/L) PROJECT DESCRIPTION Lite05e Class -- L�% LJtanSa No. � SQ�e kg - PKG. SPqCE REQ. PROV IDED OMa Si9natu�e SQ' �' . WORKERS' COMPENSATION DECLARATION ' OCCUPANCV_CONSTRUCTION TVPE STREET WIDTH . PARK FEE $ I hereby af}Irm that I have a tertiticata of consent to self-Insure or a VALUATION ZpryE ZONING APPROVED BV DATE certififat¢ of Worker5' Compen5dtlon InSurance, or a certifietl copy -eof (Settion 3 00, Lab. �,J. GRADING CU. VDS. ACRES SVECIAL CONDITIONS: �� vNo.WP81�1`�2%} GomPanY F�srYnorv+ ,;ertiTietl copy is hereby lurnlsnetl. ' REMARKS: ' � -, � Certifietl copy Is flletl wi[h tne city Builtling Division. .. . . .. . . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This sectlon neetl not be comple[eG if the permit I5 for one nunaretl � SS100) or lessl. � certlry tnat in the performanCa of the wark Tor wnlch this permit is Izsued. I shall nat amploy any person in any manner so as to �ecome PLUMBING P�AN CHECK ELECTRICAL vLAN CHECK ' i�bleCl to thC Worker5' COmpenSdtion LawS of �all(ornid. '' Date Signatur¢ BATHTUBS SHOWER$ ' NOTICE: If after making cnis tleclaration, you shoultl become subject TOILETS . URINALS GENEFiATOR 0-1 KW_'1�-30 KW �' to the Workers' Compensation provisions ol the Labor Code, You must TRANSFORMER -- � forthwith comply wlth such provislons or this permit shall be tleemetl LAVATORIES DOUBLE LAVS qPPLIANCE 10-50 KW_50 + KW - tevOkCtl. ' ' ' CONSTRUCTION LENOING AGENCV KIT. SINKS DISHWASHERS MOTORS p-1 HP_1-]0 HP • I hereby a!(Irm Ihat [her¢ is a Construction lentling agency !or the per- SERV IGE $�NKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formanca of the work !or whlch tnls permit Is Issuetl (Se�tlon 309] C��• C'�' FLOOR SINKS FLOOR ORAIN$ FIXTURES OUTLETS SWITCHE$ ' Lentler'S Name Lentler's Atltl�ess DRINKING FOUNTAINS GAS TVBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I he�e0y atfi�m lhal I am exempl trom th¢ COntractor's Llcense Law (ot the tollowing reason (Section ]031.5 Business antl Profezsions Cotle: SWIMMINGPOOL PTRAP � Any cily or county. whlch reQuires a permit to construct, alter, POLES METERED SVB improve, tlemolish or repair any structure, prlor to i[s issuance,also re� yyATER SERVICE ALTERATION PANELS MAIN SUB quire5 the appllcant to� Such permit to tile a Si9netl statemen[ thal he is lice�setl pursuant to the provizlons ot the Contractor's License Law GAS SERVICE OUTLETS SERVIGE AMP � - (Chapler 9(commencin9 wrth Seclion ]000) ot Division 3 of [he y f'�ess antl Prdessions Cotle) or that he Is exempt therefrom antl the yyqTER HEP.TERS BTU OUTPUT �_ i for .the allegetl ezemption. AnY violation of Section 7031.5 by. apPlirant for a permit sub�ecls th¢ applicant to a civil penally SEWER CONNECTIONS � • o� not more than five huntlretl tlollars ($500). ❑ I, d5 owner of the property, or my employees with wages a5 their SOLAR TANK COLLEGTORS .. . ' 501¢ COTp¢nsatlon, wlll tlo lhe work, antl the structu�e is nol InlenOetl' ' ' or o/lered for sale. (Section 7044, Business antl Professions Cotle: The SOLAR VIPING SYS. ISSUE FEE • Contractor's License Law tloes' not apply [o an owner of a property APPLICATION APPROVED BY .. ' DATE wh0 bulltl5 or imprOves ihereon, antl who tloes such wo�k himselt o/ ISSUE FEE lhrou9h'hi5 Own employees, provitletl that suth improvemenl5 are not Yntenaetl or otteretl for sale. I(, nowever, the bulltling or improvement MECHANIGAL PLAN CHECK SUMMARV OF FEES is soltl within on¢ y¢a� ot Completlon, the owne� will have the bu�tlen' � ' - � - o( p�ovin9 he tlitl not Dulltl or improv¢ for the purpose ot sale). BUILDING . HEATING SYSTEM 0-300.000 BTU '„ G PERMIT - g_� SMIP 8 ❑ I, as owner ot lhe property, am excluzively contracting wi[h qND OUCTING Ilcensetl con[rac[ors to construc[ the project (Section ]044. 8usiness . 100,000 + gTU PLAN CHECK E ' PERMIT antl Professions Cotle: The Contractor's License Law tloes not applY to ISSUANCE S an owner of properly who builds or improves ehereon, ana who ton- REFRIGERATION 0-100,000 BTU 7 iQ PLUMBING $ lracls �rom such projects with a contractor(s) licesnetl Oursuan[ to SYSTEM � GRADING � S, the Co�tractor's License Law). 300,000. BTU PLAN CHECK S � , ❑ I am exempt untler Sectlon B. & P. C. !or this ELECTRICAL S $ . BOILERS BTV ' ' — reason PLANCHECK g Mi�ROFILM g SYSTEM REPAIR, ALTERATION � Date � Owner � � MECHANICAL g�_ TOTAL FEE $ i hereby certity that I nave reatl this application�antl state that the above EXHAUST 5�'STEM MVLTIPLE � LESS AD- ' ' -- information is correct. I aqree to comply with all city a�tl county PLAN CHECK �4 VANCE PC $ o�tlina�[es antl state laws relaling tp construc[lon, antl he�eby uthorize representatives of this ci[ � to,�enl¢r upon tne above enti n tl 5a ptoperty in sectlon�p r 8bft R � � Signatu/e �� ate �"� . FINAL FEE E Drivers' Lirense or 55 � ISSUE FEE � O� CMF 0865-4b White-Bulitling; Canary-Applicanl; Pink-Hccoun[Yng; GOltlenroG-Assesso� TL CONSTRUCTION AND PLANNINGr�! POOL & SPA ' APPROVALS Permit# /'�"y�� Date Inspector pppROVALS Permit# Date Inspector � 1. Temporary Electrical Service or Pole 43. Pool &�Equipment Location Soil ipe-Undrgm - 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn ' " - - � � 45. Forms ' � "4.' Eiectrical Conduit-Undrgrn - --� 46. Electrical Bonding � - . tee ein orce - � 47. Rough Plumbin & Pressure Test � � � 6: ` Electricaf UFER Grn_ - � �' � -- ----_ti . .:, .. --48. APPROVALTOCOVER,GUNITE.... _- -- .---__. .-�.---. -_-- --_-. _ - 7.""-Pootings '- ' � - "" � ' - 49. Electrical Conduit-Undr rn "` � " ' � " � � � " 8. -Foundation �' ' "' - -- - � � - "' � �-- � 50. Gas�Pipe, ❑ Undr rn, Test � � � � - 9. Water Pipe-Und�grn- � - �-- -� 51.�� Backwash Lines P-Tra � 0 Undr rn�� - 10. Structural Floo� SVstem ' `-' -- 52.' APPROVALTO DECK - ' � it. Propeity Sewer Line & House Connection � -' - � ' � 53. Backwash.& Rece tor-Final ' ' ' � � , '� � 12. ` StFeet Sewer Connection .;.,'.•,,,:._:>_, ; . -- - � 54. Heater & Vent-Final � � � .:_ .-. . . . . : ,. _ . . , _ , _._. � ---'- - --�- -------- --' . - �13. �Roug6Plum6ing - _ _ � '! . . . - - � � - '- --- - - -- � .. . _ '-14`-R�d'ughElectricConduit' �-� -�" ""`"� 56. Electrical-Final " - 15. �Rough ElectricWiring - - - - - -- 57. Solar System-Final �.'r � �-� - . : + : - • 16. Rough Heating & Air_ Conditioning - • encing & Access Apprbva� � � ' � � ' � " ' . 17. Ducts, in Structure . '-,- � 59. APPROVED FOR PLASTERING - � ' � ' � �� 16: Ducts, Ventilating •- � � � � �� . . �� ' � � 19. Gas Pipe-Rough &Test � ' � � •- 60. POOL/SPA�SYSTEMS FINAL- .-- -- � � � _ � .� . . . ,. � '.20. Roof Framing .. ,-. . . . . � . '- . �_ . . _ . . _. _ _. , . ' -.. ... . n . .. � : ..., . 21�. Roof�Sheathin �� • ' ' • �'�� • � � � - -, � � . .�,� .. .. . � 22. Frame and Flashin ''- � ' � • NOTES: �::. ' - � - ... 23. Insulation - � • � •� • � - � ' � 24. Lathing & Siding :�i � , � 25'. Drywall Nailing � ' ' ' - � '� � • � � � - 26'. Plaster Brown Coat ' , ' . . . ' , �- . . . „ ' . . . ' 27. Electrical Power Meter-Final ' - � - � � � � ' ;`� � ' � 28: Final�Electric" �' ' ' `- � ' ' � � "� - � ' 29. Final Heating & Air Conditioning � � �� • • - � � �� ' � 30: Final'Gas Pipe�Test � �� - ' -' ' ' � � � � � • � ; 37: Final'Plumbing ' � � � � � 32�. Water Service-Final � - � � - � � � � � i 33. Gas Service-Final � �• •• � - � � ' � - ' � �� ' ' 34. �Solar pomestioFinal - � � - � � - � �. � � 35. Landsca e S rinklin S stem . � � ' - � � � � � � � � � ' � � ' �r� � 36. Sound Attenuation � � - ' ' � ' ` � � � ' • -�3Z�.-Handicap_Regulations ' � ' " - `- '�� "-' -" ' � ' " � 38. FINALSTRUCTURE&BUILDING � � ` ' ' � � 39. Special Requirements Completed • ' � � � ' " - - - -- - � � 40. Electric Release to Edison � • � - '- --" - - '- - - - � -- -� � -- -- - � - , � 41. Gas Release to�Southern California Gas Co. {' � - ' � ' ' - '---�� - - ' - ' � ' '- ' � , 42. CERTIFICATE OF OCCUPANCY - � � � � , _ � - . _ � - - - . .. .. . � No Date � - �- - - - � � .. . . .. -� - - -- � --- - - ' •- - - - � - - - - - - - -- -- - - - . . - . ' - . t . _ ,�_� 301'- 37913 v' � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely � PH1� ��-r;��,:.00 z4,:� :r�:r�5�.3� APPLICATION FOR BUILDING PERMIT EI D BV DATE ECEIV D DATE ISSUI /� a-� �� Z .-7_ , , _ PERMI� OWNEF Larwin Sout�lern California, Inc �+�P• NO. — —� MAIL BUILDING / ADDRESS 16255 Ventura Boulevard NDDRESS [� cirv Encino, California nTio�986-8890 TFiACT CANSfRUCTION EW ADD A P LENDER BRANCH 16255 Ventura Boulevard OWNER � ADDRESS Encino, California �J/, ARCHITECT _ . TEL___ .. �. USE • �' /LL� CONTRACTOR Larwin Southern Calif., Inc ADDRESS 16255 Ventura Blvd, TEL. CITV Encino, California "��986-889 STATE CITV �ic. n,o. 191311 LIC. NO. B-1 OF LOT 6� X LD�F I NOW ON LO S O USE OF EXISTING BLDG. SIZE OF NO. OF NEW BLDG. 19HJ ROOMS STORIES 1 EXTERIOF WALL SCl1CC0 ROOF WOOfl shin COVEfiING COVEFING B USE OF BUIIOING AND WORK TO BE PERFORMEO Construction single family residence I hereby acknowletlge rhat I have read [his application antl stare chat the above intormation is correct and aB�ee to comply with all laws regulating builtling construction, antl I shall not employ any pe�son in viola[ion ot the workman's compensation IawS Of the Sta[e ot California. I hereby certity [haI I am properly Ilcensetl as a contracior untler Ma State ot Calitotnia Business entl Profassions CoOe, Divisicn 3, Chap[er 9, and tha[ such licenses ate in full �orce antl efteci, or 1 am exempt from the provisions ot the State of Celifo.nte Business antl Protessions Cotle, Divi on 3, Chapter 9. SiBnet�re � Permittae � AuMorized Agent FIRE ZONE APPROVED ZON NO.OF PLAN$ VARDS APPROVED DISTANCE BET MAIN BLOGS. VAR. #` C.U.P. # FOR 1 �/(,�O THE AMO THE PURPi VALUATION $ 29,800.0 L � L` � �j�� qVALUE /� �1l«i/' $ vI! GROUP DATE' \ ) USE OF NEw BUILDIN - �� VAFDSAPPROVED � ACCESSORV BUILDING BEf. MAIN & ACCESS.BLD DATE APPROVED o �j � �(� J W FT. V � T� o i SHpWN UNDER VALUATION I$ FOR m1 OF ESTABLISHING A PERMIT FEE ONLY: ¢ PERMIT FEE $ lO1.SO j Q PLAN CHECK $ SO.7S E `o 152.25 " TOTAL FEE $ � , JOB ADDRESS A�` '+.412-£ Ih": :�:CTIONS SOIL GAS WAiER ROIIGH PLUMBiNG PROP. SWR. LINE � HOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEaTING aND nIR CONOITIONING TEMPORARV SERViCE OR POLE IINOERGROUNO � POWER � ROUGH WIR�NG BONO BERM � STEEL REINFOHCE SHEATXING FRAME AN� FLNSMING — �VT , ya PLASTER.BAJWN COPT SL.'�., _'URAL, FIN/L HEf � �G. VENT.. FEFRIG. AND A.C., F PLUMBING. FINAL AN� GAS TEST ELECTRiC, FINAL BUILOING. FINAL covriei wrn�uorururc BUILDING PERMIT N0. K Res.w att.Gar. SUBCONTRACTOR � c��, �G—/97/—� l This house is being built for a pexaplegic d the hallwqys are larger S1�9Gid than are ahown the plan. Also, the doorwqys are wider ead e urinal has been installed in the home. The eps have been removed and ramps, built with n'skid material, have replaced them. The plumbi, has been re-arraaged to meet State requirement For pa_raplegics, �,.��'.��r�, - EIAJAHD HORROCKS Bui•ldin� Official • 4232� f� ,l COSTA MESA BUILDING•SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA. CALIFOHNIA 92626 z . aU HZ ZQ O fn am J 7 J V1 Q W m J J m Q U� Za W� aW WZ J � m Z J � W W 0 ZF W � N � 70 ��, � �t! F�--r�, �-fD�2r,2�� _::,r,•�`;.SC r.,, APPLICATION FOR BUILDING PERMIT For Applicani to Fil! in Completely RECEI DATE FECEIVED DAT IS ADORESS 22 Azalea Dr " I�^' 1�� I� PERMIT NO. OWNER Robert 0, Da i4•P. NO. 41 MAIL S2.Il10 8S above BUILDING ADDfiESS .4DDRESS a ea S 8 Mesa CITV (�'OSt.B P-fesa Calif. No`�49-970� TRACT 7557 LOT z3 BLOCK CONSTRUCTION none W A ° LENDER x BRANCH none OWNER Robert 0. Da ADDRESS VALUE �O�'j ARCHITECT nOn TEL, S Patio Cover $ v OR ENGINEER � N . FIRE ADDRESS none ZONE TYPE GROUP APPROVED CONTRACTOR BV DATE ADDRESS TEL. ZONE NO.OF USE OF NE P�.qryS�/ BUILDING CITV NO. STATE nOIIe CITV YARDSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSOfl� BUILDING SI2E NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT RONT FT. USE OF EXISTINGBLDG. 5 E FT NEwa�. 16'S"�-8'7" ROOMS STOqIES �- L SIDE � FT.v, FT. EXTEflIOfl WALL ROOF �� COVERING COVEFING �th ' REAR FT. FT. USE OF BUILDING AND WORK TO BE PEFFORMED DISTANCE BET. BET, MAIN & MAIN BLDGS. ACCESS.BLDGS. VAR.# DATE Patio Cover C.U.P.,�' APPROVED � APPROVED � �I �•�� I hereby 0cknowletlgB that I have raatl this apPlication antl stata tnat the above intormatian is corrett antl apree to camply with all Inws raguleting bu�ItlinO consttuction, antl 1 shalf not amp�oy eny parson in violeti0� of the workman's compensation lawc of the Stata of CeliforniP. I hereby certify ihat I am proparly Iieensetl as a contractor �ntlar SQ. FT. the State of Calitornfe Businecs entl Professio�s Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chaptar 9, and thai sNch licenses are In tull torce entl et7act, or I TNE PURPp$E OF FSTABLISHING .�+ PERMR FEE ONLV: am exampt from the p�ovisions of the Stete of California B�siness VALUATION antl Prot¢ssions Code Oivislon 3, Chapter 9. PERMIT $ � Signature oi '--/' �� ,/� Permittee � � $ 5O Q � $ � �v Authorizatl Agent TOTAL FEE $ � �O """"' DAY Nobert U. 7- 1-76 JOB ADDRESS q�� A,a�pa n,-;.,o BUILDING PERMIT N0. i.�z�i qr-�o.41Z—Z1L-1J �v� I�::�i ":-:CTIONS SOIL GAS W RTER HOUGH PIUMBING PROP. SWR. LINE � HOUSE CON. � SPRINKLING SYSTEM MISCELLnNE0U5 ROUGX HEnTING ANO RIR CON�ITIONING TEMPORnRY SERVICE OA POLE UNOERGROUNO � POWER � FOUGM WIflING TaENCMES [� FORMS STEEL REINF. FLOOR SYSTEM BOND BEAM � STEEL HEINFOACE � $HEAtMING FRqME lN0 FLRSHING LRTMING — �N n OUT � PL?STER,BROWN COAT ST TURnL. FINAL Ht �G. VENT., REFRiG. AN� R.C., FINAL PLi1MBING FIN4L 4ND GAS TEST n DESCRIPTION oF SUBCONTRACTOR TRACT NO.' J �� / IpT N0. /� � � • ' .. � , ' � 1 . I� 1 DATE ;. � � ,' � �i: . ;i ,. . i i ` The developes of the above entitled tract deaiiea to sellithe above eet forth lot prior to the time that the tract hae been. completed and ite etreetel , j , � accepted by the� City of Coeta Mesa. `.`�j ' ,�� . � ,. The undersigned, by executing thia agreement�. acknowledges�that �._ : ' . kke�etie-they) �(�aras"Pt'wera)� advised'that'thie Eract hae , , � not been give n inspectlon nor has it been accepted by�„the City 'of Cosea Meea ae having complied with the conditione of approval which were'imposed by the City ;. , � r at the time the final tract map was approved. '•. � � �. , � . _ � _ i: The City aeaumea no liability for the enforcement of the conditione f neceesary for appx`oval other than those conditiona protacted by.surety bond. • . ..' . � ; The undersigned agrees to'indemnify and hold the City.,h�;mlese frosa aay claiai resulting in damage or peraonal injury to the underaigned by reaeon � ... ., . � ,t . of the aforementioned `ancomplated condition. _ ' �,j,:< � • � I' . ` ' , .. _ -- - . � � ' J . . . I � . � t �. . . BY / _,,,..,_,,.,..;:.::...r�- — .f. °:,°;.' r : ��.�i, :� ,.;s• , Purchaser . . . .�. .' �.� ' ,,:.' i � . . �:�::.�,!,;;.�(;:.t�:::�...;,, : , ,,,.., : ..,I.:+�.��,.. .�.F:r ';Y.,� �• . . � ./�. . �' , ,;1'•'1sr;.��.;; .�.,;��`.:,,;i'�. !�:;',: :� ; :..; ::: �, � :,;. :, �:: , ,: .: . /�, !/ ' � :.FLAPdF�ItJ(:�'dCP�f��7,'��1i i ��'� � � BY � a I . Y`�, � � � , � d �r,g�� , ' ° Developer and or suthorized .�:::. . � rCo �>,�'�+��.:��. 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