HomeMy WebLinkAbout238 ROSE LN - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA i PERMIT NO. TRACT NO � ' LOT NO BLDG.NO.
^CONSTRUCTIONPERMIT a/ 7�Y X56 6540 3/07/814 34.32 TL
•
Project Address •-.1 3 le 0 al- 1- llAi-e° •
TYPE OF CONSTRUCTION LI NS ❑ ADD L ALTERATION L REPAIR ' • •
Applicant's Maili Saar is• C�- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER,- 6 •
' A.P.#'���—� y��-/ 3 Zone —�
9y �y10'7014 DESCR14ZI0N 9�F/�ORK S s•C-- A - f
Owner's Name %a •
�4 Phone q O/ d L,� /� S Main Building: Accessory Building: .� • Z
Address ll - 0
"� Y TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION STRUCTURAL T Front 5-2-4 c 2, 5 ' N
•Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B- q n/r CI
✓J/ •
-�M� •C/ N
• Rear Y`+C N/� J
Address - '' ❑ OTHER •
Contractor's Name 0 WN'K I?U r (dIrPhone PROJECT DESCRIPTION 30. FT. - OCCUPANSV Ce C Right ,__, 3 /U G
Address(mailing) I • CONSTRUCTION TYPE VALUATION$ 'Pea s Left 0-75. / L v _ E
City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.# — - Park.Fees $ ' ' Q
LICENSED CONTRACTOR DECLARATION Remarks: U
Parking Req./Provided — - I
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: — E
my license is in full force and effect. ' / L r
License Class License No. PLUMBING FEES Planning Notes: _„..../."---&Z-4 ^�t �'1� M .
-
Date Signature S) ^ ^ ' V N'
d- ,n RKERS'COMPENSATION DECLARATION Bar Sink Showers N ,
?<Kreby affirm that I have a certificate of consent to self-Insure or a certificate T
r'±•.'Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - S
3800, Lab. C.) i Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. - Company
8 Certified copy Is hereby furnished. , Bathtubs Sewer Connection , Automatic Washer Transformer 0 15-50 KW
Certified copy is filed with the city Building Division. 0 50+KW
Date Applicant Clarifiers _ Solar Collectors Construction Pole Sub.
-
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher
(This section need not be completed itthe permit is for one hundred ($100)or Solar Piping Cooking Unit Meter pup to 100 amps
less). DrinkingFountains
I certify that in the performance of the work for whit this ppzsn issuetl I Solar Tank Dishwasher Meter Dover 100 amps,
shall not employ any person In an n so/'Ss t spcc6 a subie the - - ,
Date aS ,p sa (o-n Laws of Ca do Ma.' p .�Q7 Floor Drains Swimming Pool w/Spa • Dryers ❑Gas ❑Electric Sub Panel
x Date J oak Signature `�F N. S /�'Y
NOTICE: Ifo term Ing this declaration,you should ecome s bject to the' Floor Sinks Urinal Fan Motors 001 HP 011S-8 -
Workers' Compensation provisions of the Labor Code, you must forthwith ..
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar 09-15 HP 016-15+CONSTRUCTION LENDING AGENCY - _. - _ •
_ _
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave
of the work for which- this permit Is Issued (Section 3097 Civ. C.)
Lender's Name - Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address Lavatories
OWNER BUILER DECLARATION
DOutlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap reason (Section 7031.5 Business and Professional'Code: Any city or p Switches Sign
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 Roof Drains Garbage Disposal Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of
v Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator 00-5 KW ❑5-15 KW Trash Compactor
it {ISion 3 of the Business and Professions Code) or that he/she is exempt
✓'ictrefrom and the basis for the alleged exemption. Any violation of Section
".Yu31.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee ,$25 Issue Fee $ 3
enalty of not more than five hundred dollars($500).
I, as owner of the property or my employees with wages as their sole ' - Reinspection Fee $25 Issue Fee $ 3
compensation will do the work,and the structure Is not intended or offered MECHANICAL I FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - - - - - - - - - - PUBLIC SERVICES REQUIREMENTS:_
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0 Tf�/ K- , ) /
thereon, and who does such work himself/herself or through his or her own Zoning Approved By DI C. Date �/(7
zp
employees, provided that such Improvements are not Intended or offered for Canopy Type II ❑
sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground
pietlon, the owner will have the burden of proving he/she did not build or im-
prove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By 0/1"Alterarfer . Da
AI,as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU Dioo,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-VentilatingSUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property whoBUILDING PERMIT $ .2o- Z, SMTP Q' lb
builds or improves thereon,and who contracts for such projects with a con- •Exhaust System 0 Multiple 0 System Repair/Alteration ,$
tractor(s)6� license pursuant to the Cvptractor's License Law). PLAN CHECK $ tl3 --r�Z PERMIT
x "'l I am exempt under Section Coy
�'L/y B-& P-C,for this reason Firepl/Fact.Bit. (CBO#
en GLJ N ei i/6�`feC PLUMBING $ ISSUANCE $
Date3 _ owner: � T�>_- �•- - Heating System& Ducting _ PLAN CHECK 25% $ ENERGY P.C. $
I her e6yfiEertify (hat I have read th 5 a •
pplic-t on an. state that the above ❑0100,000 BTU ❑100,000 BTU— - ELECTRICAL $ GRADING $
informal on is correct. I agree to comply with all city and county ordinances -
•
and state laws relating to builds 9 construction, and hereby authorize repre- MICROFILM $
sentatives_ol..,this-city toent j up• J.the above-mentioned property f r - PLAN CHECK 50% $
•
inspettlon pur•oras. /` 1, MECHANICAL $
K Signature-•. . T �Et_,1�'- ' Date 3 7 TOTAL FEE $ CJ
Drivers' License or-SS 0
Accounting;Goldenrod-Assessor
' ..,QONSTRUCTION AND PLANNING ' POO 3PA
Date. • Inspector Date
Ins ector
APPROVALS :- Permit# NO(t APPROVALS Permit# •
p-
1: Temporary Electrical Service or Pole . ' . 52. Pool & Equipment Location • . " -
2. Soil Pipe-Undrgrnd. - , 53. Steel Reinforcement • '
I.
3. Electrical Conduit Utility-Uridrgrnd. • 54. Forms - -
4. Electrical Conduit-Undrgrnd. - - 55. Electrical Bonding . "
5. Steel Reinforcement if'SR't;
5TG',EC- �,/t; L 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. I - ' 57. APPROVAL TO COVER-GUNITE
7. Footings - ` _3/t/0,/ 3 f 58. Electrical Conduit-Undrgrnd.
8. Foundation t 2L 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 " 1 - - 66., Solar System-Final - -
1¢i Rough Electric Wiring - . = .. 67: Fencing & Access Approval • - --
17. Rough Wiring Sign • i _ 68. APPROVED FOR PLASTERING '
18: Rough Electrical-T Bar Ceiling ' ' 69. POOL/SPA SYSTEMS FINAL '
19: Rough Hating & 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 Frfming ' 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 &1-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 ! -
39. Water Service-Final
40. Gas Service-Final . -
41. Solar Domestic-Final • . ,
' t ' '
42. Backflow Preventer
43. Backflow Irrigation •
44. .Landscape Irrigation System '
45. Sound Attenuation • - • - 1
46. Handicap Regulations. . -
47. FINAL STRUCTURE & BUILDING -'�f9/S1 /]')j
48. Special Requirements Completed t �) i
49. Electric Release to Edison - - '
' t
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY - --- - - ' .
No. - Date' -- -
r--
TYPICAL 411 CONCRETE BLOCK FENCE .
TOP VIEW 3/8 Bar ��
I
' ,, ' ` ' ' "GENERAL- NOTES", I
(Blocks 8"BlocksI l Ill
One Part Plastic
1/4" 0 Pencil Rod Below Top ■. ' . ' I. I 1 Cement And Three Parts Sand.
II
Course Of All FencesI I I GROUT: One Port Cement And
4" Concrete Block Fence With 8" '_i_i 111
Three And One Half Parts Sand.
Pilasters. One 3/8" Vertical Barr I I 1 COPING: One Part Cement
C9ntlnuous From Eorthtooth Thru ■. ; ; . ,- ' ' ; I Three Ports Sand.
8 Pilaster. � I i1 gr Well Mixed 1:2 1/2
3/8" Vertical Ties 2' Long i � -'_ IIi ' � S 3 1/2 . Maximum Of 7 1/2
Hooked In Footing, And Grouted In ; Gallons Of Water Per Sack
4 Blocks 4 0/C Maximum. ■.� .--• I , Of Cement
'IOYIde Cleanout And inspection ' I 1 1 , REINFORCEING STEEL SHALL
Hole At Pilasters. 1
i I I i 1 I I CONFORM TO SEC. A- 15-39
III. ,
i A.S.T.M. ALL STEEL TO LAP
l i . �� `' I I WHERE SPLICED, 21-0" MINIMUM.
- GROUT MAY BE POURED FROM
. . .X II - � 1 I TOP OF FENCE IN CELLS WHERE
NATURAL GRADE ''o�.;'..'`�' • y ''.O'•'d•'.•.%,''o T, ?i';•i P.;+ ;itl.` ' 'a ' ' VERTICAL STEEL OCCURS. HOLES
iN .P.'', 'r.' C, •. til'i..•. .Po o . o.. ,..,' ,op• ' v . '.° •'01
�, FOR WIDTH SEE CHART " ' .*�'� ' 7b•�- ' ITS
' , 'a;yr SHALL BE CLEAR , CLEAN , AND
d_;o Li _.r ° .: ..;.):kris :.r- :A•Ie.._�j_.°.al �;!:,• r • o Al FREE OF ALL MORTAR , DEBRIS,
•! '!r Ia,i O'i1 ECT. WITH INSPECTION HOLES
TWO 3/8 BARS CONTINUOUS •o1 �i Jf TO 16. 0.C. MAXIMUM.' I .-04
.iF b! 1✓` AT BOTTOM. BOND SHALL BE
^-I.I' I„ ,4, PROVIDED BY LAYING BLOCKS
FENCE MAY VARY IN HEIGHT 0 ., DEPTH OF EARTHTOOTH 1/3 Ii ..I1' IN STRETCHER COURSES SO
FROM 3' TO 6 r �o I1„,‘"%e , THAT VERT. JOINTS ALTERNATE
a .-.- :,I�� 'io'61 BELOW EI BOTTOM OF FENCE 1714 � .
—%E-EC' (�}$�F B .0=3 • .,e • OE I FOOTING. r,eo�ti IN EACH COURSE.
Itn
3" CLEARANCE FROM BOTTOM r-6C1 SCALE; 1/211=
'
- CHART
HEIGHT . . . . . . 6' . . . . . . . . . . . . . . . . 5'.. • 4' 3'
• WIDTH . . . . . . . . . . 14". 14". . . . .12" . 12"
THICKNESS . : . .10" .. . . . . . . . . 10" 8" .. . 8"
DEPTH OF EARTHTOOTH . . . . . .24' . . 20" 16" . . . . . . . . 12"
SPACING OF EARTHTOOTH . . . .12'. . . . . . . . . . . . . . . . 14' .16' . .. . . 16'
City Of Costa Mesa , California OWNERS NAME:
JOB ADDRESS:
Building Department PERMIT NUMBER:
SIGNATURE:
Form BU13-2M-4-64 5-BP
•
APPROVED
s
STRUCTURAL APPROVAL ONLYi •
City of Costa Mesa Building Dept.
SEPARATE PERMITS ARE REQUIRED ; BY-14- ? 22ad1.__..DATEc"7 17 t
FOR ELECTRICAL, PLUMBING, THESE PLANS MUST BE ON JOB AT ALL TIM,S
TS
HEATING, VENTILATING AND MAKE NO CHANGES WITHOUT PRIOR APPROVAL ��®\ J�
REFRIGERATION WORK OF DEPT. [ \1+SL
6" N t'x •
THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL I Of COQ _
— "--- OF PLANS AND SPECIFICATIONS SHALL NOT EE CONSTRUED r.;' C NpUNG O r.,:.,
TO EEA PERMIT FOR, OR AN APPROVAL CF, ANY VIOLATION 20 P}D
_ �YL"i�cil #_� �� / Y OF ANY OF THE PROVISIONS OF THIS CODE. NO TERMIT PRE- \ -' ,.w-�
. THIS NUiaiBER Pin- ACCOMPANY SUMING TO GIVE AUTHORITY TO VIOLATE CT CANCEL THE �n.31r /
ALL INSPI• :WQUESTS PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO 1
\\,...
}
TAR AS THE Y ORT( OR USE WHICH IF AUTHORIZES IS LAWFIJL. 1
THE ISSUANCE OF A FERMIT EASED UPON PLANS AND
F., - _ ERSONS ARE TO SPECTECATIO:S S+ALL NOT PREVENT THE E'UILCIVS OT:L,;
bE L. _: . ,, ,_ST THAT THE PROM THEIEATiZS FEQuI.RING THE CCRRCCTIJ I Cs Laao s
ST..T'- C; .. L.r. ;;IA DIVISION OF IN SAID PLANS A.7 BPECIFICATIOL: C2 FRO' PRC/Evil .1
!ND;, ' _ s FE1 / BE CONSULTED FOR BUILDING OPERATIGNS EEING CARRIED 0'1 THEREUNDCt w
ADDITIONHL REQUIREMENTS. IN VIOLATION OF THIS 000E 00 ^' %‘", OTHEZ C.
_- .,_._. -_-�� DE THE CITY.
61 11 7 1117
lea4. or
tu
•
V I \
M RESIDENCE RESIDENCE RESIDENCE RESIDENCE
Ili3 5 •
Lu W to c7�
D: Goin
I 623 8 Los E L , -
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STREET d-
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•
Applicant to fill'in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT NO.. TRACT NO. LOT NO. BLDG.NO.
CONSTRUCTION PERMIT • M -/02 26 .
Project Address 1 R �lL.T �- PI TYPE OF CONSTRUCTION U NEW DD U ALTERATION U REPAIR 8682 A/17/04 8.00 TL
Applicant's Maiiin9- 1ddrress. ,i-s / •y ❑ CONVERSION ❑ DEMOLISH OTHER - A.P.# Zone '
Owner's Name S v r h t, 0 )4O a hrSaP�h,,orne /a 7
DESCRIPTION RIPTION OF WORK
�v f} G- O S Main Building: Accessory Building: Z
Address 23 •L$g r L hf C �,y7'YJ '%[`5 A W/' TYPE OF PERMIT ❑ GRADING U FOUNDATIO�y U STRUCTURAL
E
Front • N
Arch/Eng. License No. ❑.TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B Rear I
Address ❑ OTHER A N
Contractor's Name -�jq r 4 i Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right _ . - G
• CON ST RUCTION TYPE VALUATION$ S Left R
Address(mailing) K �� E
City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref.'$6 Park.Fees $ Q
U
LICENSED CONTRACTOR DECLARATION Remarks: 6- - //d 9-3 Parking Req./Provided1
I hereby affirm that I am licensed under provisions of Charter 9(commencing R
with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: E
my license is in full force and effect.
License Class (� /j License No. PLUMBING FEES Planning Notes: M
Date Signature /T E
1RKERS'COMPENSATION DE LARATION Bar Sink Showers T
areby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer Service Sink S
. Workers' Compensation Insurance, or a certified copy thereof (Section
3800, Lab. C.) Backflow Irrigation"• Sewer Cap ELECTRICAL FEES
Policy No. Company -
BCertified cop I ereby furnished. Bathtubs '"
Sewer Connection Automatic Washer Transformer 0 15-50 KW
Certified copy I filed with the city Building Division. 0 50+ KW
Date Applicant Clarifiers Solar Collectors Construction Pole Sub.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping
(This section need not be completed If the permit is for one hundred ($100)or Cooking Unit Meter ❑up to 100 amps
less). DrinkingFountains .
I certify that in the performance of the work for which t I5 permit is Issued I Solar Tank Dishwasher' Meter Dover 100 amps
shall not employ any person in any manner so as to come su the
Workers( o tin Laws of Calif / Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel
Date _./r-/_f - �L Signature ___ -/1' "$
NOTICE.Ii„after making this declaration, you should bec me subject to the Floor Sinks , Urinal Fan Motors 00-1 HP 01%-8
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet F.A.U. Inc.Solar 09-15 HP 016.15+
CONSTRUCTION LENDING AGENCY •
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave
of the work for which this permit lis Issued (Section 3097 Civ. C.)
Lender's Name A-.L// � Kitchen Sink Water Service Device Boxes Pole Light
Lender's Address �V Lavatories
OWNER BUILDER DECLARATION Outlets Range
I hereby affirm that I am exempt from the Contractor's License Law for the
-
following reason (Section 7031.5 Business and Professional Code: Any city or P-Trap Switches Sign
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 Roof Drains Garbage Disposal Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of
Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator 00-5 KW 05-15 KW Trash Compactor
Islon 3 of the Business and Professions Code) or that he/she is exempt .
'efrom and the basis for the alleged exemption. Any violation of Section '--
..131.5 by any applicant for a permit subjects the applicant to a civil
penaltyReinspection Fee of not more than five hundred dollars($500). $25 Issue Fee • $ 3
o I, as owner of the property or my employees with wages as their sole Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure is not intended or offered MECHANICAL FEES •
for sale (Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0
thereon, and who does such work hlmsoif/herself or through his or her own Zoning Approved By Date
employees, provided that such Improvements are not intended or offered for Canopy Type II 0
' year Duct-Under Ground Building Approved By Date
sale. If, however, the buildingor Improvement is sold within one of com-
pletlon, the owner will have the burden Of proving he/she did not build or im-
prove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By �� _'y/ Dete— /�/g111
LJ I,as owner of the property,am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000'BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who BUILDING PERMIT $ SMIP
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration $
tr, tor(s)license pursuant to the Contractor's License Law). //'/� PLAN CHECK $ PERMIT '
.4 I am exempt under Section B. & P.C.lo/ his reason / Firepl/Fact.Bit. ICBG'# 7. _
PLUMBING $ ISSUANCE $
Date 1 j Owner ,a`CX ..Ie a Heating System& Ducting _ PLAN CHECK 25% $ ENERGY P.C. $
1 here' ce tlfy t at I have read th application and state that the above 00.100,000 BTU 0100,000 BTU ELECTRICAL $ GRADING $
inform•tion Is correct. I agree to comply with all city and county ordinances
and state laws relating to building constr ction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ '
sentatives of this city t. enter / e above-mentioned pr pert for 71
inspection •.vim so ;.• /7 f./� / MECHANICAL $ 0 v _ p c ,1
Signature • Date J7 7. TOTAL FEE $ O� (l
Drivers' License or 5S-
t - $”
Pink-Accounting;Goldenrod -Assessor
CONSTRUCTION AND PLANNING POO WA
Date Inspector Date Inspector
APPROVALS Permit# APPROVALS Permit#
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 r ;
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, O 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 PLASTERING
18! Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace Sled,Per cgp 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 O Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flas;ing 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 tag( 6619
38. Final Plumbing
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
No. - Date
. _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
}T_}C�IT`IhElr COSY MESA - P IT NO. TRAQ-T, LOT NO. BLD . t•.
VONSTRUCTION PERMIT • •'•^' '' 42r3: -2/ 114/84 343.92 TL
Project Address 9-3n f&05f. Ld2nO - TYPE OF CONSTRUCTION Ll NEW ADD LJ ALTERATION H REPAIR )
t Applicant's Mailing dress . D ❑ CONVERSION 0 DEMO ISH///❑�.Osyy.THER �jr A.P.4/6 9 J/e - /. / 3 -/ 3 IZone /
Owner's Name LJ)db O A 06�1�IS Phone DESCRIPTION OF WORK �O Or0A..7 if-5---P-AA-4/1,.'aw• �w "f
• a- 9 3E eo OM HA L- / S Main Building: Accessory Building: 2
Address g leo 4 L.-el roVTI4 /SOS/} TYPE OF PERMIT ❑GRADING ft�U FOUNDATIOONN/L"J STRUCTURAL E Front � N
Arch/Eng. • License No. ❑ TENANT ❑ ELECTRICAL PLUMBING II MECHANICALB Rear j f ' N
Address ❑ 'OTHER A
k PROJECT DESCRIPTION SO. FT. _SrfZ OCCUPAN 47-' C Right am G
Contractor's Name Ly G Phone -�• �yp �s K
CONSTRUCTION TYPE Y VALUATION$ LGC £tI $ Left 2
Address(mailing) / / � e E
ZONE GRADING CU.YDS. ACRES Pin Ref.# Park.Fees $ O
City License No. g
LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided ---" U
I
I hereby affirm that I am licensed under provisions of Charter 9(commencing
with section 7000) of Division 3 of the Business and Professions Code, and pc- 97- SI Ls Use of Building:Or' R
n� p n 2QA_l�_2/1'7 C� E
my license is In full force and effect.
License Class License No. PLUMBING FEES Planning Notes: M
Date Signature E
' 'ORKERS'COMPENSATION DECLARATION Bar Sink Showers N
ereby affirm that I have a certificate of consent to self-Insure or a certificateT
Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink S
3800, Lab. C.) Backflow Irrigation Sewer Cap - 7. ELECTRICAL FEES
Policy No. Company '-
8 Certified copy is hereby furnished. Bathtubs Sewer Connection -
Automatic Washer Transformer ❑ 15-50 KW
Certified copy is flied with the city Building Division.
Date Applicant Clarifiers Solar Collectors • Construction Pole Sub. 0 50+KW
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping
(This section need not be completed if the permit is for one hundred($100)or P 9 Cooking Unit / Meter ❑up to 100 amps S^'pd
less). DrinkingFountains
I o thatm In the performance of the work for whichtjthis permit is t to I Solar Tank Dishwasher Meter Dover 100 amps
shall not employ any person in any mann-r s&.as tvv bec0 ct to the
Date t'- CgptRe/s�tl fO Li f C �� A Floor Drains Swimmih Pool w/S a
Wor O{f/ `Y�DY signature • g p Dryers ❑Gas ❑Electric Sub Panel
NOTICE: If,o ter making thiS declaratl n,you shooGul ecome sub ct to the Floor Sinks Urinal - ,Fan
Workers' Compensation provisions of the Labor Code, you must forthwith /� ,. Motors DO-1 HP ❑1'h-8
comply with such provisions or this permit shall be deemed revoked. / Gas Service ' / Outlets Water Closet 2 oo F.A.U. 1 , In0.501arP9-15"HP❑16.1$+
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures t / (/LG.
of the work for which this permit Is issued (Section 3097 Civ. C.) 7 Microwave
• Lenders Name Kitchen Sink - Water Service Device Boxes- ' ,
1 Lender's Address - - y _ P e.Light
OWNER BUILDER DECLARATION Lavatories •/ /Q Outlets . �'f
I hereby affirm that I am exempt from the Contractor's License Law for the Sig -
�•ange O�
following reason (Section-7031.5 Business and Professional Code: Any city or P-Trap Switches
county which requires a permit to construct,alter improve,demolish or repair
n / 70
any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains Ga/bag¢Disposal { .Standing Sections
to file a signed statement that he/she is licensed pursuant to the provisions of
Isat
t Contractor's License Law(Chapter 9(commencing with Section 7000)of
'r ,�Islon 3 of the Business and Professions Code) or gnat he/she Is exempt - - Generator ❑0.5 K s Trash Compactor
.y I ¢from and the basis for the alleged exemption. Any violation of Section , •
''31.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee n,
eenaity of not more than five hundred dollars($500). pe $25 Issue Fee $ 3-- i ck
LJ I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee '/ $25 Issue Fee' $ 3
compensation, will do the work, and the structure is not intended or offered FEES
for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMEN S"
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑ I� /long
thereon, and who does such work himself/herself or through his or her own g Approved By ^'// 'I ��O.
- Date4, //4/654.
employees, provided that such improvements are not Intended or offered for - Canopy Type II ❑ 2ontn A roved ///
sale. If, however,the building or improvement is sold within one year of com- Duct-Under Ground
pletion, the owner will have the burden of proving he/she did not build or im- '— Building Approved By Date
ove for the purpose of sale), Duct-Structural Refrigeration System Application Issued By
I,as owner of the property, am exclusively contracting with licensed con- } Dat Z
tr ors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ❑4100,000 BTU 0100,000 BTU SU RV OF,FEES
The Contractor's License Law does not apply to an owner of property who '
builds or improves thereon, and who contracts for s ch projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration • • i c�l BUILDING PERMIT $ t .SO •SMTP $ 2.00
tractor(s) license pursuant to the Contractor's Licens Law). �- PLAN CHECK $ 2;CZ PERMIT
o l am exempt under Section &P -..<yj reason FirepllFatt.Blt.ICBO#
I 1-- %L��_- - PLUMBING $ t - Si 00 r• ISSUANCE $
7��`'e owner w _ :MIS i-� He n System& Ductingj'
Dat - A� / 9 Y , �� PLAN CHECK' 25%' $ a SO ENERGY P.C. 1$
I hereby c rtif that I haverread this - with o and state that the above 4100,000 BTU ❑100,000 BTL'— GRADING •$
information is correct. I agree to compl with all city and county r ordinances �— ELECTRICAL $and state laws ralati n: to Iltling con tion,and hereby authorize repro. MICROFILM 4 - `
sentatives of thl to . �• above-mentioned prop.rty or , PLAN CHECK'- 50% $ 7 --,
Inspectlo- -.• i�•�� q MECHANICAL, Oo
• Signature s-
� - Reinspection Fee $25 Issue Fee $ 3 • PLAN CHECK 25% $ / •00 -
CMF 0865-46 rev.12/83 white-Building:Canary.-Applicant;Pink-Accounting;Goldenrod -Assessor
71 CONSTRUCTION AND PLANNING - POOL PA _ -
Date Inspector - Date Inspector
hI APPROVALS Permit# APPROVALS Permit#
Il. Temporary Electrical Service or Pole 52. Pool & Equipment Location ris
• 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - '
3.. Electrical Conduit Utility-Undrgrnd. -• 54. Forms "'
1 •
4. Electrical'Cgnduit-Undrgrnd. . 55.- Electrical Bonding - ,
5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test - �
i
6. Electrical LIFER Grnd. 3/a/8�' '� 57. APPROVAL TO COVER-GUNITE . • -
7. Footings! - • 58. Electrical Conduit-Undrgrnd.- ' _ + :,
8. Foundation, .5��$ S , 59. Gas Pipe, O Undrgrnd.,Test i` •'
9. Water Pipe_Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
iP Structural Floor System 61. APPROVAL TO DECK - �f' I "-_
1 L Property Sewer Line & House Connection - • 62. Backwash & Receptor-Final ' - .
12. Sewer Cap t::- 63. Heater & Vent-Final .. i.;j -.
13. Roof Drains } 64. Plumbing System - Final -
14. Rough P Plumbing 65. Electrical-Final - -
15. Rough Electrical-Conduit' - 66.,Solar System-Final - ' " ., - -.
16_ Rough Electric Wiring 67. Fencing & Access Approval . _ " .- - ""-
1
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,Nentilating 71. Product Piping 0 Gas 0 Oil
2(3. Gas Pipe-Rough & Testi 72. Underground Flush
- l 'ill , '
4. Roof Framing 73. Undergrnd.Storage Tank ❑Gas .❑Oil '
25. Roof Sheathing 4/3/z f D3 74. Overhead Hydro - - •
26. T-Bar Ceiling (Structural) & Monocoat �'/ J 75. Dry Chemical
27. Frame and Flashingfee"OAtrp ..v.,00:5/....1/8,1- j S 76. Dry Standpipe • ' ,
28. Lathing & Siding`Prpq� Y012/4./tr4AZw 1' 77. FIXED SYSTEM FINAL •
29. Insulation 4eit- f'�•A J, � ' 78. FIRE PREV. FINAL ,
30. Drywall NailingS HEALTH DEPT. REQUIREMENT . ,
31. Plaster.Brown Coat . ' 79. FINAL INSPECTION •
32. Electrical Power Meter-Final
/3�7tf 80: FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
2 .-7 9-gAi C4n3G194,+i0h 41 at
34. Final Heating & Air Conditioning ...L( p
`"eG! y -y'It. re,fl' No te . •,O
35. Final Gas Pipe-Test _3iylki./ n1�j U LT77,77,3 tJ
36. Hood.or Canopy r; ELEa_T- C it
37. Final Factory Fireplace .3/1/76 it ` ,S'//�(I
38. Final Plumbing y/z/'tj • `t o c �S
39. Water Service-Final £.X e_ .b Qn -rcir0 t geed .1,-
40. Gas Service-Final ' /`
ids Sk`('Pn2fiP/ pga,
41. Solar Domestic-Final -_: j s •S'L1,4 -
42. Backflow Preventer ,9 v
43. Backflow Irrigation J rdieer £N /yBfJ & . 07t 1/%h e
44. Landscape Irrigation System �7 nor �2e/4_ T __A, C
45. Sound Attenuation ,,.
146. Handicap Regulations '
47. FINAL STRUCTURE & BUILDING ` ,
' 48. Special Requirements Completed '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co - . _• •
51.`CERTIFICATEOFOCCUPANCY - . ,
No. Y• Date . . - - '
i' rusta Mesa Building Department APPLICATION FOR PERMIT
/ � 111 EAST 20th STREET 6 BUILDING
• COSTA MESA, CALIFORNIA s/f,
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit No.
Building 238 Rose Lane I 173
Costa Mesa, California Rece�ivyby Date Reed. Date Issued s/
.
Nearest / I/�-7.5"—fil 4�-/S-SJ
Cross St. 21st St. & Orange Ave. Building
Address
Owner Dike and Colegrove Costa Mesa, California
Mail
Address 419 E. 17th Street Nearest
Tel. . Cross St.
Cit Costa Mesa No. Li. 8-11 A ' zone/1,z ' No.of I Type ,/// crojcb J
Architect or Lic. Plans
Engineer ('.prl eon R Mi Arlt ahrnNO• Approved
by Date
'ress Garden Grove CORRECTIONS
City Lic.
contractor Dike & Colegrove No. 2707 •
Address L19 E. 17th St. , Costa Mesa
Legal I Lot I
Description No. 28 I Block I Tract2562
(Attach Metes and Bounds)
I No.of Bldgs
Size of Lot 82.0 t x 74.1' I Now on Lot none
Use of No.of No.of 1 _ : A (-1\\ 4 ` -', y
Existing Bldg. none I Families].I Rooms52 . - - - 0
Setback Line fromRear Yard 37 51 I - - 2
Center of Street 501 Side Yard ata' 1 v y
DESCRIPTION OF WORK 2• S !.11:11 r
New I X I Alteration I I Addition I
Repair I I Moving I I Demolish I - PM/ nr nnnyc nr-on
Building No.of
FJI11 Ln Vl:- - - r: -..-vii
984 sq. ft. Rooms Stories 1
.rior WallRoof
i.,,vering Fr_ Stucco I Covering Comp. APPROVALS
Use of New
Building Single Family Residence & Garage. FouForms,ndationMateLocation Inspector Date
rials,
Under-Pinning
Plan 13A Frame: Fire Stops,
Bracing,Bolts
I hereby acknowledge that I have read this Application
and state that the above is correct and agree to comply ; Lath. Int.
with all City Ordinances and State Laws regulating
building construction. Lath. Ext.
Signature of
Permittee �yDi�V "
Dike and Colegrove Plaster, Int.
Authorized Agt. l.. c.E el . Plaster,Ext.
Valuation Permit Fee $ 02 0• C-O Masonry Reinforced
Plan Check$ /Q-0•-0 Bond Beam
$ 8000.00 Total
Fee $ 3o• a0 FINAL
FORM 204 S-BP 2M 6-55
,
C u
n
O 6
O
a - a`
•
n cosrr
'1'C 1 5'551 th,,A 2Lt2T fr srr:30.N1
c •'
Street
PLOT PLAN -
Show location and distances from
property line and between buildings.