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HomeMy WebLinkAbout456 SHADY DR - Building Permits t ` • CITY OF COSTA MESA • Oit: BUILDING DIVISION i y-;IIS • wci • 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • ww . .costa-mesa.ca.us ti 4.4::: '4. Sill Po . FOR INSPECTIONS CALL: (714)754-5626 � PERMIT NUMBER: BC08-00277 PERMIT TYPE: B_COMBO STATUS: ISSUED - Sub Type: RES ALT DATE ISSUED: 07/15/2008 • ISSUED BY: RMD JOB ADDRESS: 456 SHADY DR CM Suite/Unit: APN: 11737238 Zoning: , , • Vicinity: REAR YARD Primary Occ: R-3 Const Type: V-B • SQ. FT: 375 Valuation: $34,650.00 • SCOPE OF WORK: ADD 375 SF TO SFD. WORK TO INCLUDE THE REMOVAL OF AN UNPERMITTED ENCLOSURE AND REPLACE WITH A NEW BEDROOM, STORAGE AREA AND HALLWAY WITH 1 REPAIR/ALT COOLING/HEAT, 5 LIGHT FIXTS, 10 OUTLETS AND 5 SWITCHES. OWNER: ALL MY CHILDRENS TRUST 1 Address: 456 SHADY DR Unit: Phone: 714-785-4712` - City/State/Zip: COSTA MESA, CA APPLICANT: JEWETT, MICHAEL Address: Unit: : • Phone: 714-785-4712 City/State/zZip: CONTRACTOR: OWNER-BUILDER License No. 000000 • Phone: Address: Unit: Cell: City/State: - ZipCode • ARCHITECT: - License No. PHONE: ENGINEER: H M FARD License No.0042576 PHONE:714-435-2828 COMBINTATION PERMIT FEE SUMMARY Building Plan Check: - $320.29 Building Fees: $492.75 Electrical Fees: $45.50 . Mechanical Fees: - $37.20 - - . Plumbing Fees: $0.00 SMIP Residential: • $3.47 SMIP Commercial: $0.00 TOTAL FEES: $899.21 '-Refer to fee receipts for all tees paid for project • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. ODE 1, INSPECTION TYPE PAS INTTALs CODE! INSPECTION TYPE DAT; 0111110.$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 3-25'7 r • I . lit' WORKERS'COMPENSATION DECLARATIO• - Owner ID verified by dScense. /es 0 No 1 I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: (Z(1 O ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership compensation, as provided for by section 3700 of the Labor Code, for the b y(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Cartier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap. 3.2,Grp (Trus seam need nor be competed a the permit Is valued at one hundred dollars(aroo)orress.) 2 Art 2Sec.341,Title B,Califomia Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would gI certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date th Labor Code,I shall forthwith comply with these provisions. -Z( 5-t GC NC1> Division of Industrial Safety Permit Number: m's iBnature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons. or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file y license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes ❑No Li..# A ASloss --. (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 W mors Sig .'Ila" • Dale 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Daie 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303 five Bred dollars($500).): of the California Health and Safety Code). I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other . ompensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No 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 8. (If yes", attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). .- completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF.COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). • information given above is correct. I agree to comply with all state laws and 0' I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of • Signature - Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF•ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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 • auth•rized by this permit until final inspection. • ature of Legal• errs to I - — Date - . •57-4613/07 i " - -- AndrorAuthorized ApPhCant Date COMMERFORD INSPECTION INC. DEPT.OF DG. & SAFETY PAPAYA DRIVE LA LA HABRA HEIGHTS, CA 90631 CITY O .244 (562) 690-3198 or (562) 690-2883 /l ��]� FAX (562) 690-4887 COUNTY OF On a`-� SPECIAL INSPECTION REPORT Building Permit No. I1/' — / Job No. �[�4J D�at/e� /e4/05- Job Identification/Address drtad 1YC7 , L!/! General Contractor/Address �Y/l Asez ee:47 C_,„ Sub-Contractor/Address diet,Structural Engineer/Address .1é34 • '--�(��/LZ TYPE O- ••I 'K:: REINFORCED CONCRETE MASONRY HI-TENSILE BOLTING 40X PRESTRESSED CONCRETE WELDING GYPSUM CONCRETE /"'ELDER RECEIPT NUMBER WELDER RECEIPT NUMBER DATE OF INSPECTION p DESCRIPT ON OF W.RK INSP CTED: /2-713MiasS � , t eio , /9? 12A 'S I� Q� �� 1109, i 1,101 pi, aff a M'1 its Jn. HOURS / D;/� 2( te- Reg O.T. N TINT OA /�t/v31v® SAMPLES Grout Mortar Concrete Block Prisms Density All inspections based on a minimum of 4 hours &over 4 hours- 8 hour minimum. In addition,over 8 hours and Saturday will be billed at time and a half. ATTORNEY'S FEES- If any action at law or in equity is brought to enforce or interpret the terms of this Contract,the prevailing party .shall be entitled to reasonable attorney's fees,costs and necessary disbursements in addition to any other relief to which such party may be entitled. SPECIAL INSPECTION REPO'T // / A Cildia Inspector N e: g '1 � �' CC) S Inspector's Signature: u/I �C�(- ///i I.D.NQ,, S ll has been filed and it states that the above work to the best ., his/her knowledge complies with the provisions of the Unif. , Building Code and meets Approved Plans and Specification. Respectfully Submitted Approved by: By Project Superintendent Commerford Inspection,Inc. COMMERFORD INSPECTION INC. DEPT.OF BLDG.&SAFETY 2269 PAPAYA DRIVE LA HABRA HEIGHTS, CA 90631 CITY OF66Th-M (562) 690-3198 or (562) 690-2883 n- ,..��, FAX (562) 690-4887 • COUNTY OF 0, "�.. ^SPECIAL INSPECTION REPORT Building Permit No. g ����//�//pc>4:\`- Job No. /� � Date �+�� --/ Job Identification/Address 4I5& S14AD`( P(2._ CoSt`Rrt 4 S9- . 2•W 6.2-- FLS General Contractor/Address GQ4 t ee 4 3-UL I I- Z-17-4-1E-11- Sub-Contractor -17-4 1Fv`I'T'Sub-Contractor/Address (�I t V 11 CStructural Engineer/Address . •A • FJA-€c.r&cA___ TYPE OF WORK: REINFORCED CONCRETE K MASONRY HI-TENSILE BOLTING PRESTRESSED CONCRETE WELDING GYPSUM CONCRETE WELDER RECEIPT NUMBER WELDER RECEIPT NUMBER DATE OF INSPECTION DESCRIPTION OF WORK INSPECTED: 1C a•c • rziMgtie le" 5(.D c .a. gaq- `nPg 15 nT RwnUrG c.d.". gEA C L My ex/STt&6 (edgy( v.( 51 PSoar- Sic-e1 geo�vrZcc IS-►A2Ia-a-�. Ai t4, ta• S rLw cU UcwZ Wct /, ,Ati 'r- og (z-�I oic 4( 4 2.02- -c.9) W AT- is .o.� . t•3 Pm t"a c, Vi.vm w t'rounpc, mint_ p rat cyr 1 ?a/ 5 6--\ Fir•"4 Awn �s LA,Sc.4.61)tA4 . �56 I A-R Q-3" cat_ 5L41-. HOURS Date Re O.T. TIME IN TIME OUT R--Ito tiY q tp„ SAMPLES Grout Mortar Concrete Block Prisms Density All inspections based on a minimum of 4 hours&over 4 hours- 8 hour minimum. In addition,over 8 hours and Saturday will be billed at time and a half. ATTORNEY'S FEES- If any action at law or in equity is brought to enforce or interpret the terms of this Contract,the prevailing party shall be entitled to reasonable attorney's fees,costs and necessary disbursements in addition to any other relief to which such party may be entitled. #r SPECIAL INSPECTION RE T Inspector's Name: I�rQ! , Inspector's Signature: I.D. Nod t/13•-�has been filed and it states that the above work to the best o is/her know •dge c lies with the provisions o the Uniform Building Code and meets Approved Plans and Specification. ak-CL Respectfully Submitted Approved by: By rojec[Superintendent Commerford Inspection,Inc. • • 9 CITY OF COSTA MESA ' BUILDING DIVISION s •4 •,,,.' ,i'c DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER o .; /: PERMIT E07-00290 � l (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaEIECTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 456 SHADY DR status: ISSUED Suite No Applied: 04/05/2007 Vicinity: A/C UNIT Issued: 04/05/2007 Parcel Nunmber: 11737238 • Applicant: PENSO, JOHN (/���6�)�, Address: l./ Phone: 800-503-2666 ISSUED BY: Zip Owner: GIBSON, LARRY Address 456 SHADY DR Phone: COSTA MESA,CA- Zip: 92627 Contractor: ECONO AIR, Address: 3101 ENTERPISE STREET Phone: 800-503-2666 BREA,CA Zip: 92821 License:445220 SCOPE OF PERMIT • ELECTRICAL PERMIT FOR NEW A A/C UNIT LOCATED AT REAR YARD AND CHANGE OUT(E)HEATING LOCATED IN CLOSET FOR A SFD. REF#:M07-00176 WORK TO INCLUDE:1 RES A/C PACKAGE • _ I- FEE SUMMARY Quantity Quantity . ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 - Busway/100 ft $0.00 0 _ Res.a/c package $54.50 Standing'Section $0.00 0 . New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 - up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 - up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 - Low Voltage Equipment $0.00 0 Res Appl $0.00 0 - Low Volt Wiring System/Ckt ..$0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 , 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 , Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 / 0 Motors to 10hp $0.00. 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 - • 0 Fireworks Stand '$0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp -$0.00 0 _ Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee - $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $78.00 Intermed Pole $0.00 0 • 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is:suspended or abandoned for a period 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(8/00) 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'compensati./.' urance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. L My workers'compensation - rance carrier d policy umber ' are: Carrier: I - - Ara. cc) IPy - . c/-cl� s�1J( !/l 6a (This section need not be completed if the perm'Is valued a •ne hundred dollars(5100)or less.) ❑ I certify that in the performance of the w•. for Air ' t s permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and :.ree —- s .uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions.�/ Applicant Signature: Sill 4 1 - ' 4—v^' CDate17 WARNING:FAILURE TO SECUR- OR .'5'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),I` •ORION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter corn�. r.in; , h Section 7000)of Division 3 of the Business and Professions Cade,and my license Is In full fore and effect.tic.# / Class M e../ ,Contractors Signature: o Arno- Date: ( ^(sem O 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: Lenders Address: Signature: 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).): ❑ 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 properly 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: Owner ID verified by drivers license. 0 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(38)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. Signature: Date: 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? 0 Yes 0 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? 0 Yes 0 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 acutety 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 Safely Code been fully complied with? 0 Yes 0 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 ermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? l3 Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 Will any partof the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 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? 0 Yes 0 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 ins,.:ctionnppurposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Sign: 0 Of al Owner(s) Date o i 1,a' Pd� O __ --s- O A d/a _u •nzed Applicant _ t _pate , CODE I IIISPECUON TYPE PLTE INnIMU 000F! INSPECTION TYPE RAIL ?BMW 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing . -,� 200 Final Re-Roof 210 Final Electrical w Ofi ,Ae A ` 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place ! 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy •yam .DIM OF COSTA MESA t , BUILDING DIVISION Y• ..i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F I I PERMIT M07-00176 Jo�� (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 456 SHADY DR Status: ISSUED ' Suite No Applied: 04/05/2007 Issued: 04/05/2007 Vicinity: HALLWAY CLOSET Parcel Number: 11737238 Applicant: PENSO, JOHN , , ISSUED BY: Address: Phone: 800-503-2666 Zip: Owner: GIBSON; LARRY , ' • Address: 456 SHADY DR EX �Y„S.. Phone: • ( i a COSTA MESA,CA Zip: 92627 DAVE a k Contractor: ECONO AIR" - Address: 3101 ENTERPISE STREET Phone: 800-503-2666 BREA,CA Zip: 92821 License:445220 SCOPE OF PERMIT ' MECHANICAL PERMIT FOR NEW A A/C UNIT LOCATED AT REAR YARD AND CHANGE OUT(E) HEATING LOCATED IN CLOSET FOR A SFD. REF#:E07-00290 WORK TO INCLUDE: 1 INST<,100 K BTU AND 1 COMPRESSOR 3 TO 15 HP. " FEE SUMMARY f Quantity t Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit i $0.00 0 Inst FAU<100 k BTU $14.80 1 . Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator 50.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 03 To 15 hp/500 k BTU $27.15 1 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/.1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 - 0 • Over 50 hp/Over 1,750.BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp . $0.00 0 Inst or Relocate Appl Vent . $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 ' 30 to 50 hp ' $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp - $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee . Floor or Suspend Heater i $0.00" 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee ' - $0.00 TOTAL CALCULATED FEES $65.45 COMMENTS I SPECIAL CONDITIONS • • 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: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period 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 required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expitiation of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS 1 ' 1 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. _0-1 have and will maintain workers compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which thi rnit is issued. -.My workers'compensigion Insurance carrier and policy number are: - - . t-Ci O ! CrCartier: G�C 7he 6 '/�� � Policy Number. �� ((�L`, p L(This section need not be completed if the permit is value .ne hundred dollars($100)or less.) ❑ I certify that in the performance of the work for ic• t is permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and,tree a f s •uld become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: v_/i./i /// /2 !Dere:- 0 WARNING FAILURE TO SEC • c-1 ERS'•• -ENSA ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,o00),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am titans d under psgvjpnJ is pt: mencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full farce andeftect.Lic.4 2t4&-- - Class al -e-/ O-7-0 Contractors Signature: �_.-,/.1 !/e/' Date: % *St 0 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). Lenders Name: Lenders Address: Signature: 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).): ❑ 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 properly 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers 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,faisework,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. Signature: Date: 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? 0 Yes 0 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? 0 Yes 0 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 tiling 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? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aggermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes u 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? 0 Yes 0 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? 0 Yes 0 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 slate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described pro% ubiiLnt' tion• •osesI agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. / LDate '\t CODE 0 INSPECTION TYPE PATE EMU • CODF1 INSPECTIONTYPE - OL �1 4fi 1616 Fixed System Final Fire Prevention 206 Final Mechanical L'--/ /- - (g� 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof - 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign it 222 Final Site 204 Final Demolition 250 Final Building/Occupancy e 1-3 4 e 3 w APPROVED CITY OE COSTA MESA PLANNING DIVISION SUBJECT TO BLDG. DEPT. REG. NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. BY: �\ `� DATE, 6/ dl 1\IC \J k— ADDRESS OF BUILDING: 456 SHADY DR DMT' CITY OF COSTA MESA - BUILDING PERMIT OM'NeITS NAME IF KNOWN: GIBSON, LARRY PERM NO: P 075431 • Ammo: GIBSON, JUDY ' 456 SHADY DR PERMIT NO: P 075431 PLAN CHECK NO: N GOVT : N SUPP : N COSTA MESA, CA 92627 APPL.MAIUNG ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH ARCHRECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : C/O DISHWASHER SQ FT: ARCH.OR ENG.'S ADDRESS: UHT: CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 / CONTRACTORS NAME: NOCK PLUMBING ( 714 ) 895-1246 CONTRACTORS MMUNG 11610 SEABOARD CIR COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: STANTON CA uc.No.: 511971 **************** '+('*-x****iax-*N-*+t****AE***x-+ ***** -******** *********** -**-*->F******** 90680 DMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I ern Icensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license I,in full force and effect. CrRYUC.NO.: 050386 DC.CLASS: C-36 UC.NO.: 511971 EXP : 02/96 MAIN BUILDING ACCESSORY BUILDING - `` ate: �/ ' (� 3 FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Contreaa: Nb LJM �/QC) LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN . 'WN BUILDER DECLARATION:I hereby affirm under penalty of perjury that lam exempt front the Contractors License Law for the Ito g reason(Section 7031.5 Business and Professions Code:Any city or county which require,a panne to conswcd,aver,improve. PARKING REQ: P ROV: PARCEL : 11737238 Z N E: REF NO: amolish,or repair any structure.prior to es 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(oornmendng with Section 7000)of Division 3 ol the PLANNING NOTES> Business and Professions Cade]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subjects the applicant toe civil penalty of not more than five hundred dollars($500)). **********************************************9E*******1E***1F******-************** ❑ I.as ov er of the property or my employees with wages as their sole compensation,will do the work.and the aNwture is not intended DEVELOPMENT SERVICES' R E U I R E M E N T S or offered for sale(Section 7004.Business and Professions Code:The Contractors License Law does not apply to an owner of property Q who builds or improves thereon,and oho does such work Nmset or herself or through his or her awn employees,provided that such 1- owprovementsere not intended air offend for sale.U.however.the building or improvement is sold withinone year acompletion,the ZONING APPROVED BY \. ner -builder will have the burden of proving he or she did not build or improve for the purpose of sale). DATE: ❑ I.as owner of the property.am exdusivety contracting with licensed contractors to construct the project(Section 1004.Business and �1 Professions Code:The Contractors License Law does not appy to an owner of property who builds or improves(hereon end who BUILDING APPROVED BY : .... DATE: contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). �, N ❑ 1 ant exempt under Section: B.A P.C.,for this reason: APPLICATION ISSUED BY: `I/ DATE: Date: Owner *-IE*-****1F****-**3F*****-***********7FiE4E4EiE**** iE 9r******************** • • ' - ** LEGALIZATION: N F E E S USA R Y STRUCTURAL SEGMENT:N I do hereby certify that I am aware of end understand the requirements of California Health and Safety Code Sections 25505,25533,and 25534,and that I or any future building occupant will I wit not(circle one)need to comply wth said slate codes and the requirements for a permit for construction or modification from the Ai aiy anagement District ResideMidoonsUWion appmeten are exempt from Nese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 7 , 00 Date: Applicant: 25ci _ SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedaretions: PLAN ,1n IS ❑ I have and will maintain a cendcate d consent to'off-insure for workers'compensation,as provided for by Section 3700 of the Labor B U I SUE FEE 2 0 . 0 0 Code,for the performance mwework anwhlehmepema .acted. UILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE n I have and all maintain workers'oampenalion insurance,es required by Section 3700 of the Labor Code,for the performance cl the TOTALS----> 7 . 00 20 . 00 L7 0 . 00 27, 00 27 . 00 . 00 work for which this permit is issued.My workers'compensation insurance carrier and polity number we: Carder STATF EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 27 . 00 OVER/SHORT: . 00 Policy Number: MWr17111100 09 /30/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed I'the perm&is for one hundred dollars($1001 or less.) 27 . 00 ' certify1that in theperformance of the work for which thispermit is issued,I shell not employ ❑ any person in any manner so as to ' become subpa to the makers'compensation laws d Califon' agree that .. N become subpa to the workers' ******************************************************************************* compensation provisions of Section of the Labor Code,I h comply with t .-, gmAeiem. ate: — C/ ? Applicant:' - - I N D I V I D U A L F E E B R E A K D O W N ova Ing:FaOurofoaeeuroworkers' onpmutloneoverpebvn/awNl,and abllsubject mamployxfocdMnwtpenalNuand TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST I I fines up to one hundred thousand dollars($100,000A In addition to Me cost of compensation,damages as provided for In �' . ectlon3706ofthe Labor Code,Interestand attorney's fees. PLU 1 DISHWASHER ., 7 , 00 7 , 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES performance of the work for which this parent is issued(Section 3097,Civ.C). A LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and wanly ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. ', SON NO _ !f q �j� LATE: !1'_>�01. ;i'I r =b� '4 Signature of Ovate' 7.t VC!trador/ (5151i6.WP) White-Building 8 Safety;Green-Ale:• . ppicant:Pink-Revenue;Goldenrod-Assessor .CONBTRUCTION AND PLANNING - i & SPA APPROVALS Permit# Date Inspector 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 UF ER Grnd. 57, APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 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 Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERIING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating- 71. Product Piping 0 Gas 009 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead 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 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 -t - 33. Final Electric. Notes: 12: ?4 -S'5 Ffritr-4-? •�f 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final.Factory Fireplace • -"1 38. Final Plumbing - [ r'- S 4 . 9 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backf low Irrigation 44. Landscape Irrigation System • . • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRU TIO PF�RMIT PER NO. TRACT NO. LOT NO. UNIT NO. Project Address 466 A a 91 ss IEEE �, • Applicant's Mailing ddr C�JQ / TYPE OF CONSTRUCTION H NEW ❑ ADD LI ALTERATION yo REPAIR Owner's Name �� Phone VQ 9is ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.4 Zone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ UNDATION ❑ STRUCTURAL E Front o Address .7 ''�� 1 / ❑ TENANT ❑ ELECTRICAL ....PLUMBING ❑ MECHANICAL B Rear N . Contractor's Name LU_�'4af rs. A - , Alkali's�J ❑ OTHER A y PROJECT DESCRIPTION SQ. FT. — OCCUPANCY C Right G Address(mailing) ir%Lnr7 K CON ST RUCTION TYPE VALUATION$ S Left City License NO. - _ ZONE GRADING CU.YDS. ACRESR LICENSED CONTRACTOR DECLARATION Ping. Ref. 4 Parking Req./Provided E 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: PlanningNotes: - - 2 t9 Q with section 7000)iof Division 3 of the Business and Professions Code,and - n 111t '• 17fl7 M my license is in ful. • e and effect. t rRF VE' IndI T Liven " C s __ ! ,' e•-e N..,IP • 4 s nate r /a Ara- Signature ��a% i A 1 4 • PLUMBING FEES • DRKERS'COMPENSATION DECLARATION Bar Sink • Showers .tereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - k 3800, Lab. �/]/n.? ii_27 `� /_ypp / y� �� Automatic Washer Transformer 0 15-50 KW +� Policy No. /7 "/C7 d" / Company Sjtt t i�� t,(/ Backflow Irrigation Sewer 0 50+ KW Cap Construction Pole Sub. ertifietl copy is hereby furnished. • Ces4d''l�¢p"��op .ssifiled with the city 1 In. 11 Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps Date t7• -6 / Applicant �v 1 EXEMPTION FROM WORKERS'COMPENSATII DE LARATION Clarifiers - Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I shall not employ any person-in any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors❑o-1 HP ID Y2-8 Workers' Compensation Laws of California. _ Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc:Solar 09-15 HP 016-15+ NOTICE: If,of ter making this declaration, you should become subject to the - workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY GasService Outlets Water Closet Device Boxes ' I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors /e Water Heater Outlets Lender's Name - Range Lender's Address - Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code; Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays / Generator 0.5 KW❑5-15 KW any structure, prior to its Issuance, also requires the applicant for such permit - Trash Compactor 'b,Pay file a signed statement that he/she is licensed pursuant to the provisions of Roof • Drains ::-1 Contractor's License Law(Chapter 9(commencing with Section 7000)of Fq;;ision 3 of the Business and Professions Code) or that he/she is.exempt - - Y-Nerefrom 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). - LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee - $ 3 for sale (Section 7044, Business and Professional Code:.The Contractor's MECHANICAL- ' FEES 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 ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If; however, the building or improvement is sold within one year of com- Canopy Type II ❑ , . Zoning Approved By - Date pletion, the owner will have the burden of proving he/she did not build or int- Duct-Under Ground Building Approved By _Date prove for the purpose of sale). - - I ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat a— tractorsto construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU - SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- _ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple D System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their worker's Compensation insurance should be provided to me. _ - - PLAN CHECK $ - PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers W PLUMBING $ _5, ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN• CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 1:10-100,000 BTU ❑100,000871-M ELECTRICAL $ GRADING $ information is correct. agree to comply with all city and county ordinances- - and state laws relating to building construction,and hereby authorize repre- sentatives of this city to enter pan the above-mentioned property for • _ Q� inspection nose• • MECHANICAL $ TOTAL FEE $ S'� Signature / - Datee'1 () / Drivers' License or SS$ • • Reinspection Fee $15' • Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ttia 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 Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, b1Undrgrnd. 10. Structural Floor System 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 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 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead 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 78. FIRE PREV. 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 /Nil> ja< • 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation - • 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co / 51. CERTIFICATE OF OCCUPANCY • ..i No. Date r I , OWNER VASS, Alfred IJ. DATE 10-3-62 JOB ADDRESS 1456 Shady Drive BUILDING PERMIT NO. 17965 GENERAL CONTRACTOR Parker Construction VALUE $ 2870.00 AP No.117-371-26 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Add Fam.An. to INSPECTIONS Signature DATE GROUP I TYPE v ZONE R-1 lies Soil PEP ITS ISSUED Gas SUBCONTRACTOR DATE NUMBF Water Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop.Swr.Line 0 Rouse Con. 0 St.Swr. ❑ Sprinkling System Construction Pole Underground ❑ Power Rough Wiring Trenches 0 Forms 0 Steel Reinf. C Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing — In 0 Out 0 Plaster, brown coat Refrig. 0 Air Cond. ❑ Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final Building, Final OCCUPANCY /gig/6 3 ead.Astt/f ac/ry r , ( FORM BU4-5M -- 7.61 / 1W6) ) "/3/4, 3 C/ ecce, l aer ILL RLCULIVLLO D OCU E 3 1962 965 FINANCDEPT. COSTA MESA BUILDING-SAFETY DEPARTMENT CITY OF COSTA MESA i P. O. BOX 317 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING //��1 /,J/�JJ� �y�f BUILDING ADDRESS �v ,///Tv/ _Aso(v� COSTA MESA. CALIFORNIA For Office Use Only N2 -/ . /0jr. / // :, I RECEIPT Na. I J7 T.tr OWNER///'f 1.1///l�Y<f/ 'fL/ L////,HJ / Y MAIL 3 L /„ '-j) n Q v / RECEIVED BY I DAT ECWED,)l E IS UED2 ADDRESS n (l7.CfY J/�j A✓f .// n I ,r{ •C --s--4.b �/ �1. /" gJ / 4 /%614 NO. Q 3/2 BADDILRESS AR` 'ECT TFI COSTA MESA. CALIFORNIA OR ENGINEER NO. - ADDRESS -- FIRE D' .{y�� �J�/ //� ZONE TYPE GROUP RA✓A CONTRACTOR / �/) ////4D C0///J r • APPPROVEDIEF BY DATE/0 3/11 ADDRESS -Z/a ' 6/8 v... / ZONING �� /f �j -A ZON / I NO.NO; I Butte OP NEW / CITY dg�Y/nn/A/// �//fr /./�� H/''�//y/� (P/U/NO Iy��<1 , Butte Orri G/l/ 4P I• L� 7},. SIZE BL ITC.NO. //� 7 coN0O NO. "_ -/ /{I // DESCRIPTION 541L (/�/�., esti/3 VASA" o OF LOT (V 1nJ'1 ,// C I! / /I7NOW orN LOOT/Sym - A.P.NO. / 1 9 — 3 / /— h "`((( EXISTING BLDG. J//✓ a1 G G Al 1�- // /L'�/ YARDS /EVES 7._ APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.1 74 CENTER OP STREET 0 REAR YARD / FRONT �7 -c--) ✓ IN. SIDE YARD I LEFT r I RIGHT r R.SIDE /• / FT. / IN. _ DESCRIPTION OF WORK L.SIDE _ / I Ftt•--' SL IN. NEW 7 Il ALTERATION I X I ADDITION 1( REAR 'II `/� FT. /�t IN. REPAIR I V MOVING I II DEMOLISH APPROVED if/ /?,‘ 111DATIIIE / -/ _� � BUILDING/t (,,/ / [IND. OF / BY '✓✓✓Q 1 SIZE 'Q to �7�10 ROOMS STORIES1v ROOF I COVERING EXTERIOR WALL /CCfI COVERING a USE OF BUILDING/(ANND WORK TO BE PERMED /6,7-A7 /Ly /r'odnl 02 p _, --,e_ . /9 /7)4h is '61/ DF.l'c/ ann° I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COW PURPOSE OP ESTABLISH I NG A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRU N. VALUATION /n/ SIGNATURE OF Xn PERMIT FEE $ as 00 PERMITTEF r C�P ^ �� o U / / - $ aX �D PLAN CHECK $ 4.00 E i / V A HORI EDGE $ /R.no D TOTAL FEE u OWNER TOBIAS & ORR ✓ DATE 7-20-54 JOB ADDRESS 456 Shady Drive BUILDING PERMIT NO. 409 GENERAL CONTRACTOR Dike & Colgrove VALUE $ 9,000.00 LOT APP#117-371-20 BLOCK TRACT Residence GROUP I TYPE V ZONE Rth FIRE DISTRICT #1105 INSPECTIONS • •TE. SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench uu -12 Foundation Forms and Grade to Garage Rough Framing SGC fo, ' _ Plumbing,Rough to Slab )1.6-10 jig Cr'p - Cc)04 flt ' %I f Plumbing, Rough Complete 4 a5 c, ' A {�j iL/4.4.a2 J y.-02,..5-,_ fail_ Temporary Pole Wiring, Rough �s >1Oi.—m_2�✓ /7-Sc sf o 7 Heating,Rough 2e < 7 Heating, Final 5€1/i y y/�� Sewer �v/S - • 2...,/C 1--ca" t p dl ,`c eXl3X (2,10 Septic Tank or Cesspool .0O 'tic. Lathing ""e--C e �' — bin : C Plastering t 4' , Plumbing,Final,Fixtures Complete k /2-3 l' . . Plumbing,Final Gas Test /4-/4- `i 1 I ,f 3 ..--A.CrF ' C e ii . LZ-7.., .- 1 f ( Wiring, Final >t-? ../s�3 'h :31 ` I-- Occupancy -21 t .'9 ' z,j J jG Form 210 G-H 1M 12-63 Costa Mesa Building Department40 APPLICATION FOR PERMIT _ • • �► 111 EAST 20th STREET BUILDING 14 / COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY - FOR APPLICANT TO FILL IN 1 Receipt No. P r it 7. Building Q-/ ? 'b Address 456 Shady �fl o� Costa Mesa, California Received by Date Recd. Date Issued Nearest 7-i d-SY Cross St. It-Vine Building Address Owner Tobias & Orr Costa Mesa, California Mail Address 393 E. 17th St. Nearest Tel. Cross St. _ City Costa Mesa No. Li. 8-1139 Zone No.of Type , / I Group Architect or Lio. Y�I Plane y (/ -clineer Hugh Gibbs No. Approved by Date ..dress 441 E. 1st St. Long Beach CORRECTIONS City Lic. Contractod)Ike & Cole! ove No. 170 Address 41 E. 17th St. Costa Mesa LegaiPart Lot US I lq ort His Description No. City of Costa Mesa (Attach Metes and Bounds) �/ - 3 7/ —.7-0 . A rlah h\ I No.of Bldgs. / _ ■ . Size of Lot 60 1.35.09 Now on Lot none ��r �'J Use of I No.of 1 I No.of 6 i.r- • z Existing Bldg. Families I Rooms GA 6 Setback Line from Rear Yard 80 _ AML 12 194 Center of Street 501 -Side Yard 1() D DESCRIPTION OF WORK New I X I Alteration I I Addition I al of OM MESA `Renair I I Moving I I Demolish I ~ ling 1 No.of .. 1160 Rooms 6 Stories 1 Exterior W ll I Roof Covering Paster Covering Comp. APPROVALS Build ngNw B Foundation Location Inspector Date 9 Rani r3gnre Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath.Ext. with all City Ordinances and State Laws regulating building construction. Signatu Authorized Agt. ^d%�`i Plaster,Int. Permittee (� �d/ Plaster, Ext. Authorized Agt. Masonry Reinforced Valuation Permit Fee $ G y Plan Check $ 'C Bond Beam D $ 70-ft-ti Total Z��_1 __.._ Fee $ FINAL rnau Pr,/ fi•H PM 5-Sit . d C o J • J 6 o 0 0. a` • P. yy Ma ? r; • • :Street •• ;4 iPLOT-PLAN Show location and 'distances ifromi •- I.t property line and between buildings. OWNER IIRDO, MA, °a MAO* Re D• DATE WI 1 3 1364 JOB ADDRESS 456 Shady Drive BUILDING PERMIT NO. 23 .5 •- _ GENERAL CONTRACTOR VALUE $ AP No. LOT TRACT FIRE ZONE DESCRIPTION OF WORK DET. Gar._ INSPECTIONS Signature DATE GROUP TYPE ZONE Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. t] Air Cond. ❑ Rough Heating Rough Plumbing -. Miscellaneous Prop. Swr. Line❑ House Con. 0 St. Swr. p _ Sprinkling System Construction Pole Underground D Power Cl g f z-/t;-6`1 Rough Wiring /(4//f/c//(4//f/c/ i tete- • /74,14iA3'7 i 2 [' Trenches i Forms Steel Reinf. ❑ Al /W y Floor System Bond Beam 0 Steel Reinforce 0 Sheathing .t'., 17-A7%y Frame and Flashing Lathing — In,p Out ID Plaster, brown coat Refrig. ❑ Air Con. ,p Final - 'Heating, Final Plumbing Fixtures, Final _ Final Gas Test Electric Fixtures, Final 23075 tFEE RECEIVED s COSTA MESA BUILDING-SAFETY DEPARTMENT - OCT 13 1964 P.O.BOX 317 COSTA ME5A.CALIFORNIA FINANCE DEPT. CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING / ,A For Office Use Only ADD ESS 41st c#,4D Y 02/VF_ . `,l/_r • RECEIPT NO. PERMIT NO r.- COSTA MESA, CALIFORNIA 2 3 'j 5 n/� n�t T / (� RECEI•([pFY DATE ECEII)fl DATE ISSUED OWNER f tb1/4ri ,4.U• 1/A /b4 7( (y0- �O//3/6 r/ Q !!! BUILDING /�! �, / ( DR— FIRE ADD 7 /q.p.le 0/2l v6 ADDRESS ^/ `P '4(IO ADDRESS S� 7� ' N [[� // ,�,, MnL. ZONE �� TYPE7 GROUP / '�J��//^'l(,y//�� CIT._ T 0,2 /✓/ Ci NO. /�Lb(Q(� A. ::ECT O/Zd Iv66 CO • TEL.L(• BYPROVED .z DATE/O 5' GA__.GINEER NO.f-314 1 /JrI /'TS / /f ZONING 'G/ ADDS ESSa 7S . lift l97Tr• JT. C / M ( .I�� J�{� .41 I'L !C At ' WI.!R l.-V g 411...LY- 6_ I I NO. > I BUNEW � / Rb(G a O PLANS BUILDING 8 t CONTRACTOR 1 LEGAL 1 ( Q ADDRESS DESCRIPTION o RI �Ljn nu CITY A.P.NO. 1 ( / - 3 a- 3 � NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL 30'TO SIDE a REAR P.L. LIC.NO. NO. EAVES OLX OT /O SI/ }} I F NO.OF BLDGE. .2 ALLOWED (U.B.C.REQUIREMENT/ !O /7,�I NOW ON LOT YARDS APPROVED YARDS APPROVED USE OFq/J // MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. fiew.IPU[c y� FT czh�tlw I,�'///��I SETBACK LINE FROM _ • __ it -- CENTER OF STREET REAR YARD GGGIII SIDE YARD I LEFT I RIGHT R.SIDE Pi / FT. .,c. DESCRIPTION OF WORK ;Zr-FT. ( // V REAR FT. L Fr. 1/ ALTERATION _ ADDITION ( Ili- NEW DISTANCE BET. BET.MAIN& MAIN BLOCS. ACCESS.BLDGS. REPAIR MOVING DEMOLISH DATE BUILDING NO.OF • APPROVED SIZE ROOMS STORIES EXTERIOR WALL ROOF / - Iil.ii,Iffi / /Q j�/COVERING C OCOVERING eaey' 0I ' l/ / b . USE OF BUILDING AND WORK TO =- PERFORMED' I r?al'hir ` e AC ed ,at.- a r .. ,,p , : I .J 41 /t(4 /GLr4 PL- /l(//K G! �9l-NO . 26</ s Qq e'"o0zr - o I HEREBY ACKNOWL060E THAT I HAVE READ (HIS APPLICATIONI THE SHOWN UNDER VALUATION IS FOR THE I AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION /'DO m BUILDING CONSTRUCTION. r/ N SIGNATURE OP PERMIT FEE $ /..� j PERMITTEE AMOUNT B �J kI� . 3,06? PLAN CHECK $ �73 AUTHORIZED AOEN_y((/ TOTAL FEE $ 2..e, ._,_fro n UWNtK VASS, A. UAIt .3-15-13 JOB ADDRESS 456 Shady Drive BUILDING PERMIT NO. 36227 GENERAL CONTRACTOR D. W. McFerran DESCRIPTION of WORK Patio Cover APNo117_172_38 LOT 118 TRACTNpt. Hts FIRE ZONE . VALUE $ 870.00 INSPECTIONS Signature Date GROUP J TYPE IV ZONE 121 SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ k SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER n . ROUGH WIRING Heating and Vent. TRENCHES ❑ FORMS 9 STEEL REINF. 9 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN 9 OUT 9 PLASTER, BROWN COAT STRUCTURAL, FINAL _ Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL see//1 n^ -3-a3- ; 4 • 36227PAID :•,', :.., 'AR i5-73z11-,.9i 50.9•: '-9.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA.CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY DATE RE IVEDk DAT/ ISS E ADILDINGDRESS ys"� 5i,`,zO/ 7,2' G( � c i/rr-a �,s ,3 AC- ADDRESS / �^ ?fj .�7 OWNER A/ A.c l A.P. NO. 1(7-372-- JO J •.- MAIL ll //�� BUILDING �I--/ CiV� ^ P ADDRESS LU U.I /�•y�6av4 ADDRESS n./Pr.J.vi-6 // C U CITY ` t / NO.TETRAC {/1 TSI LOT /1 BLOCK QF COLENSTRUCTION 1) , ) . NEW }AZ!ALTER {REPAIR (MOVING DFMOI ISH _a BRANCH !� A/ /j En OWNER VAss ADDRESS VALUE ,I W m m ARCHITECT i / / / TEL. _ 0 • ` $ - O J Q OR ENGINEER �/ p�4.6 / NN• - a f �f�.; FIRE aK ADDRESS // f— �i(/./ Jy.SI /`�I tcCS/ /(-/y/r ZONE /� '/ -• JO CONTRACTOR ifC �;L APPROVED /i/,� DATE e ' OD z JCC ADDRESS 75-7D a/T7tQERJ �/u-Dy� AL.vt•L1 10.IUYFl W W [ ZONE P NO.OF USE OF NEW.�T Z e /1 TE / /� ft. PLANS 'Z BUILDING r� I J L/ CITY tN�' S7 NO. VJJ36-�7 L(1 I LE (_ �Z W U STATE � CITY YARDS APPROVED YARDS APPROVED r co CC LIC.NO. "// 74L yy t LIC.NO. MAIN BUILDING ACCESSORY BUILDING D U SIZE NO.OF BLDGS. (FROM C/L STREET) ���((./}pal//it(n OF LOT NOW ON LOT ROW \ FT. �""" FT. USE OF >>-- ('� EXISTING BLDG. "Th.: !a R SIDE .5 FT. F• SIZE OF 35(7 5 NO.OF Wit-CO Z NEW BLDG. X ROOMS STORIES L.SIDE CL,rA�(�(.QFT. \ EXTERIOR WALL / ROOF ��// 1-,COVERING COVERING REAR FT. -10 FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0- MAIN BLOCS. ACCESS.BLOCS. C VAR.# DATE QI- /p- /X(/�/,�\LJ ��,/(/L//��,N f C.U.P,# APPROVED ^t N V �. .- 1 -40-Li zu APPROVED LULU f� DATE J -/S- / Z �Tla Y 5S pt6 UI hereby acknowledge that I have read this application and state /J\ 0 that the above information is correct and agree to comply with CP L' cc all laws regulating building construction, and I shall not employ s ~ any person in violation of the workman's compensation laws of (A the State of California. 1l''' m m ZI hereby certify that I am properly licensed as a contractor under SQ. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR i Chapter 9, and that such licenses ere In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: a am exempt from the rovisions of the State of Cali rnia Business I and Professions Code 'vision 3,Ch ter 9. VALUATION �jDO m PERMIT FEE $ N / I APV// /j D Signature of r /, / /�/ ,A,f L // (J L� b m Permittee f ,( NVLWG et $ 1C 7 �--� PLAN CHECK $ !� E Authorized Agent - 8 A , eat (// ar D� LL ��t/✓`t r --G'-'*�C� TOTAL FEE_.S, _:-.z� • O NER KASPER, PHILIP-& ROSE MARIE t DATE 11-14-56 JOB ADDRESS 1'56 Shady Drive BUILDING PERMIT NO. #3950 GENERAL CONTRACTOR Owner Bldr• VALUE $ 900.00 AP117-371-26 LOT 118 BLOCK TRACT Npt. Hgts. Hobby Shop, Pvt. GROUP J TYPE III ZONE R(j FIRE DISTRICT 3956 PERMITS ISSUED I 1pyii / / / " /0*, SUBCONTRACTOR DATE NUMBER R FootingtTk4�DD IV� _7`) JFoundact :Rough Framin fi �/ e Plumbing,Rough to Slab Plumbing,Rough Complete Temporary Pole —�arrvnn Wiring, Rough FEb 5 ■uy 4,,Q,,,,,,v„J ,7_ -.S-7 3 y a c, — Heating,Rough Heating, Final Sewer, House Sewer,St. Septic Tank or Cesspool t)h(�l. - Lathing, In Out �V-�'+' Plastering Plumbing,Final,Fixtures Complete _ Plumbing,Final Gas Test Wiring, Final FEB 5 1351/ yE$...rrrfff Ca�(��� , ' - -� j�G� Occupancy ' / a7 – 6 �s / FORM 210 3M 10.55 / loCr1 --G`s : Mesa Building Department APPLICATION FOR PERMIT n+ . ,.-., 4 P. O. Box3!7CALIFORNIA 39S6 BUILDING 1 .'r--r•- FOR OFFICE.USE ONLY • ©R' AEPLICANT TO FILL IN Receipt No. I Permit No. Building 3 Address / Jr .. ,1,-...9.,1,-...9., A / • 9LS-0 Costa Mesa, t'•1 llfornia Received by Date Reed. Date Issued Nearest /"} (� t,/ // ° - / — /5/-fG Cross St. 01.1.4"-t...-4.4...4, Building - Address Owner •( �►-„,�}'r Q 4:9111.10.44, Costa Mesa, California Mail 6D n �1AI Address ya , L ,4A; -AY u . Nearest 0 , Cross St. City h..-,i�rw J77.•lt.tom No. 4 q rzone �.1i No.of I Type Group Architect or /.♦` Lie. y Plans / • engineer CX/,AS-..-1„. !� No. Approved /SSI by <<-' -� Date ol dress �'( 1 0 City Lie. I,••' ° u ' �' y ,+ ContractorL.— No. A L .. Yj. V' T Address CITY OF COSTA MESA Legal Lot ati � • ..,ANI.-.:.5 i:r'I . Description I No. 11 s” I Block I nt )) (Attach Metes and Bounds) / / 7- 3 7/ - z 1, No.of Bldg — / •• _ r L; so es of Lot I s.Now on Lot I BYfi PI AN T•r�-29/ llse of urI No.of I I / of A Existing Bldg. Families Room? ) (� / El 9e46eek.7.twei�rn � Rear Yard /® -/-iii-' Q� • CPntne"'"- 3Ot Side Yard / \ � DESCRON OF WOR A S, - 5 ").-iso QZAto � New I X I Alteration I I Addition I o_Repair I I Moving I I Demolish I •C ding No.of . /PS 3 J Rooms / Stories / Exterior Wall Roof — Covering CG.i'C ♦ -[ Coverip• tom. . APPROVALS I Use of New _ , S / ,_t Foundation Location Inspector • Date Building "/./.7( J Forms,Materials, J f Under-Pinning Frame: Fire Stops, �• Bracing,Bolts p I hereby acknowledge that I have read this Application o and state that the above is correct and agree to comply Lath. Int. Al with all City Ordinances and State Laws regulating building construct/ n. Lath. Ext. Signature of / l''7 Permittee L-411t1/�22i /A.eL 7 : Plaster, Int. Authorized Agt Plaster,Ext. CO MasonryReinforced •0 Valuation 0 Permit Fee $ �© Plan Check $ Bond Beam C $ Total / C Fee $ (�J -- FINAL FORM 204 1055 O.P.G S. t 'IV Y C Y J C d J • a a I • •. V. . : • Street • PLOT PLAN Show location and distances from property lino and between buildings. L A 0 CA 0 0 OWNER VASS A.J. DATE ` 5-16-79 JOB ADDRESS 456 Shady Drive BUILDING PERMIT NO. 48048 GENERAL CONTRACTOR Wayne Howard Constr. DESCRIPTION of WORK En1&roe Kitchen & Be' . Z A• P No. 117-372-38 LOT TRACT FIRE ZONE VALUE E 15,000:00 _ Qt INSPECTIONS Signature Date TVPB' GROUP I ZONE R-1 V SOIGAS SUBCONTRACTOR PERMITS ISSUED GAS Dote I I NumberSignature 'p7 WATER a` R• OUGH PLUMBING no ice 1`.-,p I - ` ILe_M t�`� � 'c (e,--) 1 tytO bj C PROP. SWR. LINE ❑ HOUSE CON. C1 t - !!- `", }L.J ) / SPRINKLING SYSTEM MISCELLANEOUS /''� q� ROUGH HEATING AND AIR CONDITIONING C).a tp,o,v, TEMPORARY SERVICE OR POLE }/-�', art UNDERGROUND 0 POWER 0 n �pT�/,�Ip_n'�,g.®.�/ {I {I II P ■ ROUGH WIRING C.c 7 fl_'J7 Meatintl Ye11t. `L, c• 111 A!I TRENCHES `Yf FORMS Li STEEL REINF. 7 a,�, r IA)(LA pc) ,{ ^. :s FY76q. Gib FLOOR SYSTEM ✓ 24 1 ( ff � u i 'J 6 BOND BEAM n STEEL REINFORCE n LLLNNNUUU �I 777 4 SHEATHING _ OAT6 FRAME AND FLASHING�HIB�L/ �L�a ( UNUER DIRECTION 1 t> LATHING - IN 'ylOUT `,� 7- Y-������777JJJ \OF BUILDING URICIAL/ �9 P• LASTER, BROWN COAT /.11, I. q. 7--W STRUCTURAL, FINAL /I//- Elppp tric —u ♦� e� _ HEATING, VENT., REFRIG. AND A.C.,Pr I (� LUIr1A/tiC KOCJh2•7 s-- c---- Aia- /vJ9`� PLUMBING. FINAL ANO GAS TEST Pr LT. L.- Ar Le+�•I p� L7 b 'J(a/NdP ELECTRIC. FINAL C,c_ /p•'jl... t x 1 R BUILDING. FINAL Incomplete InSUeCtiuns • �� 8593 5/.16/79 109.055 T`` I 3 8593 5/16/79 109.08CKTh COSTA MESA BUILDING-SAFETY DEPARTMENT; 8593 00004480 48 �Q P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 . APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only BUILDING '/ // l RECEIVED BY DATE RECEIVED DATE ISSUED ADDRESS I_ J a • ) �7 /1/1/ OWNER \_.CX_ L /O 2L4) A.P.NO. II7 - - /s� 3 PEELS MAIL ` ��/1^ BUILDING ADDRESS .J 6 4 / 1 a., ADDRESS 45 Sh(,t(J'�/ Dr 04,019;2_,,, /n✓�'A _ it"W PT- IOd.p CITY 1�Qi , / NO.t 1.-03/a TRACT//EI 4.7-S. LOTfI Ti . BLOCK CONSTRUCTION NEW A DALTER REPAIR MOVING DEMOLISH LENDER /.v�J\/` BRANCH �j, `, OWNER 4_ 3- V S I j ADDRESS t�r L/A � / VALUE c' ------ ARCHITECT --� ARCHITECT TEL. USE 4 - 6V-7 Q/L'i $ /✓ 1� OR ENGINEER NO, Vi :' FIRE {-- ADDRESS ZONE GROUP .. /CONTRACTOR Or r I '44-4� ` BYPROVELEYPE DATE —/�— G9 ADDRESS ///to / /� ///��� l - 1 TEL /'7 (� ZONE I NO.OF USE OF NEW CITYI / NO.�31-N / �tt PLANS . ` BUILDINGA A j— 1 F4 STATE / r/y, f CITY L YAHUS AfrriUVCU LIC. NO.J3-I 3s/ 9 7 - LIC.NO.O 7//11.7 -AAAIN-B'" ' NNC ACCESSORY-04÷1t9iNG Lil SIZE NO.OF SLOGS. IF ROM E -STAEET)Y/{. O. OF LOT NOW ON LOT FRONT (�sr•JM_Ll��_-s/I�dl Q USE OF C EXISTING BLDG. R.SIDE 3 C-F1% 0 ca•Si. FT. O to _r�-- � � NSeparate permits are required for L.SIDE FT. CO Q-l.�•�€T-Lek- electric,plumbing and heating work. cis-�j 0 l REAR FL r�0 FT. n USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& <Q MAIN BLOCS. ACCESS.BLOGS. ..1 _�Q R- OQoSA' 1 C U.P.# DATE APPROVED a>'• y rN APPROVED CO/el-a' uCDATE Che /77� ..,__A .1 re O. I hereby acknowledge that I have read this application and state in n. Ig that the above information Is correct and agree to comply with a• all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of x the State of California. gbleT-13 CO C; I hereby certify at I am properly licensed as a contractor under co the State of C: ifornia Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, an•'that,such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: vs am exempt t m - - 'visio •f the State of California Business a and Profess'�s Co._ •ivi to Chapter 9. VALUATION PERMIT FEE $ r (0 n /� ®�� PLAN CHECK $ / O� 'n Signature/1 �f C/ ,�// Pe rnitte ���r ="S. A $ �Q TAX $ Q J_I U Authoriz:• •ge _ J TOTAL PAID $/O� ©5 ve5r .Shady JOBWY"nib ts456ady BUIL, 0-4-00) JOB ADDRESS Drive PEBUILDING PERMIT NO. 25995' GENERAL CONTRACTOR Continental Const. DESCRIPTION OF WORK Conn. Block Wal 1 No. 117-372-38 LOT TRACT FIRE ZONE VALUE $ 1$0.00 INSPECTIONS Signatuj¢ Date GROUP J TYPE ITT ZONE R.-1 Soil PERMITS ISSUED Gas SUBCONTRACTOR Date I Number I Signaw,e Water Plumbing Rough Plumbing Prop. Swr. Line ❑ House Con.CU Sprinkling System citMiscellaneous _ Rough Heating and Air Conditioning Temporary Service or Pole Underground 0 Power 0 Rough 0 Powe - "6"-/ /C�6 Heating and Vent. Trenches 0 Forms 0 Steel Reinf. 0 IIY t' /45 Floor System f / GGC Bond Beam 0 Steel Reinforce 0 Shea thing Frame and Flashing Lathing— In ❑ Out ❑ Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final Plumbing, Final and Gas Test 0 Electric, Final Building, Final 1t c. ii/ /0 MIA] 7 Vv -- • 25995 AUG -9-66 00 525a2*****3.00 i,COSTA[MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 317 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING For Office Use Only BUILDING ADDRESSI'I'56 Shady Drive RECEIPT NO. PERMIT N / COSTA MESA, CALIFORNIA ,C) r'S RfiC�H V�8 Y g DATE RBCHIV D ATE IBSU OWNER Mr. and Mrs. G. Vass 9 � �_9 r' BUILDING 44,63„ ' � MI-Rasa AIL 456 Sha ADDRESS ADDRESS 5 Shady Drive FIRE TEL: ZONE TYPE OUP CI- Costa Mesa NO. APPROVED A, 'ECT TEL. BY DATE OR-..GINEER NO. ZONING ADDRESS ZON NO.'OF USE OP NEW CONTRACTOR Continental Construction Co. 7)-J I PLAI}S BUILDIV / bnit ADDRESS 1220 Ea'st Pomona DESCR /�. • t 6/`( _ k 11 c& LEBCRIRIO �) �-�/ d" CITYJOAn . &na A.P.NO. 3 )gyp EL NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATNE O.. 202487 T 547-5868 SO•TO SIDE&REAR P.L. ,EAVES SIZE I NO.OF SLOGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT Dwelling YARDS APPROVED YARDS APPROVED USEISTOING F BLDG. MAIN BUILDING ACCESSORY BUILDING EX � 1 �� ��� � (FROM C/LOFT. " . -." R-e a"�^`^"'��' CENTER OFSETBACK INE STREETM REAR YARD FRONT SOFT. / (/ 6: FT. // Q ( _ ' �'._i� SIDE YARDI LEFT RIGHT R.SIDE 0 FT. O 6 _ n4Fr. — u DESCRIPTION OF WORK L.SIDE FT. FT. NEW X ALTERATION_ ADDITION REAR FT. FT. DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH -MAIN BLDGQ. ACCESS.SLOGS. BUILDING NO.OF VAR.# DATE SIZE I ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL ROOF APP �J- —r- �j2 COVERING I COVERING BY W`�L cf _.41 DATE D `�' v USE OF BUILDING AN WORK TO B :PERFORMED U� block wall "Z'ft. 4164 4x8x18n ��fJc& Flo' X S� X " C� �vt s I HEREBY/ACKNOWLEDGE T I -HAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE tAND STATE THAT THE -•VE - C;�T AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY •-DI / STATE LAWS REGULATING VALUATION m-Q S BUILDING CONSTRU . PERMIT FEE $ N SIGNATURE OF PERMITTEE G Vie) / PLAN CHECK $ o AUTHORIZED AGEN v 2. TOTAL FEE $ . Uwrve,tt YAZD, Pin. tie PIM. A. U. DATE •- JOB ADDRESS 456 Shady Drive BUILDING PERMIT NO. -23075- GENERAL CONTRACTOR Owner-Builder VALUE $ 1069.00 De Pvt.Gar.4 AP No.117-372-38 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK COr&7Oar.tn Lv. INSPECTIONS Signature _ DATE GROUP I TYPE V ZONE - R1 Soil PERMITS ISSUED Gas SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. (] Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line D House Con. 0 St. Swr. ❑ ___ Sprinkling System Construction Pole Underground Power d] _if"? /2-16-6y Rough Wiring 0,, a? /��4��,16;G4 —�[� N/�5//V 2 3 / F' Trenches n Forms ❑ Steel Reiff. j _fl4' KLi/6/ Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing m _ c /!/a/( Lathing — In,[a Out❑ — Plaster, brown coat Refrig. a Air Con. 0 Final Heating, Final Plumbing Fixtures, Final Final Gas Test Electric Fixtures, Final _.__-- Ruild:nn Rin..l _ _ - —. 1!J IQ - _ o.L - -- _