HomeMy WebLinkAbout2905 ROYAL PALM DR - Building Permits 0 -'v.. - ..
CITY OF COSTA 4MESA
� BUILDING DIVISION '
1' .1 - • DEVELOPMENT SERVICES DEPARTMENT PERM! UMBER
Ne - •ra PERMIT
- a.mi0 02-00069
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDING PERMIT
Job Address: 2905 ROYAL PALM DR Status: ISSUED
Suite: Applied: 01/16/2002
Vicinity: HOUSE&ATTACHED GARAGE Issued: 01/16/2002
Parcel Number: 13929415 Zoning: R1 R1
Applicant: SANDKAMP, GEORGE . ISSUED BY:
Address: 124 N SULLIVAN#C . ' -
. - Phone: (714)542-1742
SANTA ANA;CA-.: Zip: 92703 • `
Owner: TYLER;MARY ELIZABETH TR -
Address .2905 ROYAL PALM DR -
` Phone: -
COSTA MESA,CA Zip: 92626 - ,
•
Contractor: SANDKAMP ROOFING
Address: 124 N SULLIVAN#C
, - Phone: (714)542-1742
. SANTA'ANA, CA - - . -
Zip: 92703 License: 362896
Arch : , ' - - Eng: - ,
Address: •
Address: ,
- - Phone: Phone:
-
Zip: • _ - License: ''License: -
SCOPE OF PERMIT
/ REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(29 SQ),TEAR OFF EXISTING LAYER OF
COMPOSITION SHINGLES,.INSTALL 2-LAYERS OF 15#FELT UNDERLAYMENT,&REROOF WITH 25 YEAR COMPOSITION
SHINGLES.
,.
-- - - - . -FEE SUMMARY
Plan Check: $0.00Calc Valuation: ` $4,000.00
Permit: $97.25 Claim Valuation: ' - $4,000.00
. SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00 .
Inspection: $0.00 .' .,
-Total: $97.75 - -
' PLANNING &ZONING ,
SETBACKS -
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front ' 0-0 Rear 0-0 Left 0-0 Right 0;0
PARKING Existing: 0 Required: 0 • ' -Proposed: 0
NOTES:
li
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
1 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
2446-48(eroo) _ _ _
WORKERS' COMPENSATION DECLARATION:
Elk
I hereby affirm under penalty of perjury one of the following declarations: '
❑ 1 have and will maintain a certificate o1 consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
�
❑�I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued.
My workn'fompensation Insurance carrier and policy number are:
'Carver:_ �/D.T E= FV" 17 Policy Number. 2�' – I %��
.(This section need not be completed it the permit is valued at one hundred dollars ($100) or less.)
❑ 1 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 workers'
compensation laws of California, and agree that it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with these provisions. iX Q
Apps to Signature:- y �� ��� Data: -_///61 A Z
WARNING: FAILURE TO SECUR ERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUWECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES,
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license is in full
force and effect. Lia N -1 Clas� s Al C
—.
Contractor's Signature:
CONSTRUCTION LENDING AGENCY:
❑ 1 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: Lender's 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 property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. it, 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
Cade: 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.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ 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:
❑ 1 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, falseworx, 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? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
...or.pr..s. an. -..or future buiidin...... ......'..... ..........................................
2 Does or well the applicant o pre t e g occupant need to file a registration form for acutely hazardous materials. ❑Ves ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
.................................................................................................................................................................................................................................................................................................................................................................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
...................................................................................................................-................................................................................................................................................._............... .............................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes
❑ No
..................................................................................................................._....................................................................... ................................................................... epli...............a........................................................................... difi................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this ,,a,,ppplication epermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ 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 pan of the facility to be construcietl under this permit be within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
...................................................................................................................................................................................................................................__............................................ ........................ -..... .............................. ...........................................
7 If a Permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
..................... ...............................................................................................................................................................................................................................................................................-.......................................................
B (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 props y for insp . nes. I agree not to occupy or allow Occupancy of any building authorized by this permit until final inspection.
SigJetura Of Leg I Owners) 'ate
l__tE0YG2_1n PX 11r],.in Y� I -/—G-7
And/Of Authorized Applicant A L±—
Data--CODE t. INSPECTION TYPE 2&U ISR 6S CODE INSPECTION TYPE 2&U jig
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 . Final Re -Roof y Z 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 BuildinglOccupancy
saw aw
ADDREfur FBuimm: 2905 ROYAL PALM DR UNIT:
OYINENSNAMEIEIWOMN:MARRY TYLER
ADOREsS2905 ROYAL PALM DR
C.M 92626
,*ft. IWUNG ADDRESS:
ARCHITECT OR ENGONEER: UC.No,
LRCM. OR ENG: S ADMIESS: UNIT:
CON"MACTOR'S NAME
CONTRACTOR'S MAILING
ADDRESS:
M. NO.:
UNIT:
LICENSED CONTRACTORS DECIARATION: I hereby allbm under penally of perjury Ihe, I em licensed under provisions of Chapter 9
(Commencing with Section 7180) of Division 3 of the Business end Prelusona Coda, and my license a in full forte and affect.
CRY AIC. NO.: LIC. CLASS: AIC. NO.: 0 EXP:
IData: Contractor:
OWNER BUILDER DECLARATION: I hereby affirm under panely of perjury Ihw I em exempt from the Contractor Liosnae Lew for the
fdfowing reason (Salon 7031.5 eusnres end Prefesons Code: Any coy «counly which requires a permit to mnebucl, eltw, improve,
�doh, «repel any structure, Prior to its eauame, aso requires the applirent Iw such perms to fib a agrred wwement that M «she
sensed insurers to the provisions tithe Contractors License Law ]Chaprw 9(oommencing wish Section 7") of Division 3 of hs
stns and Professions Code] or that M or she is exempt Ihwehom and the beers for Iran alleged exemption. My violation of Section
, 1.5 by eery applicant for a perms sab]eow the applicant to a civil penalty of nal more than five hundred dollas ]5500)).
] I, as awTfar of the popery or my empl ices mh wages as thear acts compensation, will do the wait, and the structure I. not intended
or offered for sob (Section 7044, Buems and Professions Code: The Contractors License Law does no appy to an carat of propend
who Wada or inprovae!hereon, and who dos such wont kmself or henelt «through his w hat own empic see, provided Iha1 such
impovamens we not intended «offend for sale. B, however, the building «inprwameM is sold within ort year of oomplelon. the
owner brilder will have the Wrden of pming he or she did not build «impose for the Purpose of sale).
❑ I. as osa er of the propend. am exduerve y contracting with licensed contractors to cmdrrnd the project (Section 7(W4. Businwa and
Professions Coda: The Contractors Licema Law time not may to an ownw of preperry who Wilds «improves thereon and who
contracts for such prryeas mh a contradicts) licensed unuam to the Contradwe license law).
—exam
un Sector: B. 8 P C., 1« this to 4r a //
ate: a 3 Ownec �/j�,y,(�lh(� - iyA'l///ice
1�ddoh,vetbyf.ftl toot I am awwe of and undeotend the requirements of C le Health and Safety QOlSections 25505. 25533, and
25534. Bad tow 1 «any future Wildbg moorent will / art cot (circle ort) need to comply, wlth wad state codes and the requirements M
e permilfwmutmcton or modigmtion h«ntMAi eiiaTy F.rwsgement Diwnct. Residential omwnwon eppfimti«s we axwnpt from these
proriaiona.
Date: Appicanl�
WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one, of the folowing dedarmims:
❑ I have end well maintain a cenRicde of bureau! Io sell -insure for worker' compensation, ss provided for by Section 37M of the Labor
Code. for the pwlwmame of IM work for w h this perms is issued.
❑ 1 have wk wil malntait worka%compensation Insurance. u required by Section 3700 d the Labor Code, for the performance d IM
work for which this permit a issued. My workers cwnpensetion insurance owner and policy number we:
Camey:
Paley Number.
s aedicn need no, be complaed 0 the permit is for one hundred dales ($1001 or les.)
I L] I candy that in One pedormance of the work for which this mrmit IN isued, I shall cot employ ary person in any manor so as to
become subject to the wakars comperfaotan laws of California. ant agree that d I shook become subject to the w ahem
compensation pmviskare d Section 37W of the lahor Code. I shell lonhwdh campy with those Provisions.
Dena: Applicant.
Warning. Fallum as swum molows' compsrwUoo coverage /a unlewl0l, and affair suhNor an employer to cdmlrfal ps ndo" end
civil Ross W 0 one hundred thousand dollars ($104000), In addition re he roar of compensation, damage as pmorked for In
Section 3705 oy Ms Labor Code, losses,, arch adonosy's feu.
CONSTRUCTTON LENDING AGENCY: I hereby affirm under Penalty of perryry tow Ihere is a wouuctim lendtng agency 1« Ihe
performance of the work for which this perms is esund (Section 3097• Cis. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I candy that I have read this eppcation and slate tow the above information u mnect. I agree to Campy, wort all dry and county oMine«es
and state lever relwmg tb Wilding com uction ant hereby atdhorixe representatives d this city to enter upon the abate men innnd popery
for inapwren purposes. MARY TYLER
lwm Dale: .17 -
4 ' pmlura 1 Owmr nVAppAcenUConuectw
war as as
asese
(515145.WP) Whiro-BuildElg 8 Safely: Grean-Fle: Canary -Applicant; pink -Revenue; Goldenrod-Msssor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 077324
PERMIT NO: B 077324 PLAN CHECK NO: 01530-96 L GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: CON
JOB DESCRIPTION CONSTRUCT 368SF OPEN TRELLIS PATIO SQ FT: 368
CLAIM VALUE: 1,600,00 CALC—VALUE: 5,733.44 GROUP OCC: R-3 /
COMMENTS: X
9E 9E 9E fE BElE*iE 1E 9E RE 9E BE 9E dE iE 1E RE 3F 9E BE dE)EjElE**1E 9E*ii iF iE iE*Rf iE*dE RE BE BE fE fE 9E 9E 9k 1E***lEiE*3E 1E iE*lE ii BE**9E 1E*9E 3E RE*RE RE RE**fE 9E )E iE
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ----------
---------
ACCESSORY
BUILDING---------
FRNT: FT
IN REAR: 21
FT 6 IN FRNT:
FT IN
REAR:
FT IN
LEFT: 6 FT 2
IN RGHT:
FT IN LEFT:
FT IN
RGHT:
FT IN
PARKING REQ:
PROV:
PARCEL: 13929415 ZNE: R1
REF NO:
PLANNING NOTES>
CONSTRUCT A
PATIO COVER IN THE
REAR YARD.
BElE 9E RE 9Ek1E FERE 9ElE 9E RE 1E SE iE
dE BE BE*1E iF iE lE iE iF SElE
iE iE jE*lE iF 9E iE RE RE*RE RE dE RF SE*SE**SE IE 9F IE*1E Rk iE RE***SE
iE*ib*Sf*iE *RF iE RE dE*1E 9E 9E iF*
D E V E L
O P M E N T
S E R V I^µ C\�\ E S
R E Q U I R
E M E N
T.S
ZONING APPROVED
BY
� � ` I T/
DATE:
�'
�" ,. _
I .,
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
iE SE iE RE RE iE RE RE * if iE lE lE * k 9E BE BE * 1E RE if
LEGALIZATION:N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 112.25
PLAN 72.96
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS ---- > 112.82 0.00 72.96
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
112.25
DATE:C
DATE: /
STRUCTURAL'iSEGMENT:Y
FIRE SMIP/RES] GRADING
57 ,
SMIP/NON—'RES
TOTAL PAID DUE
185.78 185.78 .00
185.78 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
.57 72.96
!E BE Bf RE RE 1E iE RE 1F iE * Sf Rf if 1E RF if BF * * RE RE BE BE RE fF SE 9E BE fE * * 1E lE 1E jE 9E 9E iE RE * * 3E * 9E * iF 1E RE 9F RE iE9E RE dE RE * * RE RE 9E lF iE 3E 9E * RE RF iE 1f iE ik'IE 9E iE lF iE fE BE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 368 RES—PATIO COVER—POST 6 TRELLIS
END OF FEES
15.58 5,733.44
b
01 -t-0T !, „•v
DATE; D4,'23/95 TIPI-: ilial
CONSr(RUCTION AND PLANNING
APPROVALS Permit # Date
4 �'
Inspector,
POOL PA
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
' .7
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
' S. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd:
J
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, Hough Wiring Sign
68. APPROVED FOR PLASTERING
18, Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL' -
19. Rough Heating & Air Conditioning -
t.
FIRE DEPT. REQUIREMENT
APPROVALS Pgrmit #
20. Rough Factory Fireplace
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.StorageTank OGas 00il
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
33. Finalbectric
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
- -
42. Backflow Preventer
43. Backflow 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
-_
f !
NOTE: SHOW AND DIMENSION PRi111RENSAPPROVED
POggEEpD ���I
AR& ONS, DELETIO S, O. CORRECTIONS SHALL
PATIO COVER AND YARD BY THE PL NNINIG DEPARTMENT
Z
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----------------
�Iz� �Z�OCr
IVISION OF BLS G SAFE
CITY OF COSTA MESA 1
I APR&ft1uL T% I
27�
t of plans and
speciflcatlons MUST be k t
tunlawful to make any chars on this fob at d 6
Perms ion from the D v cion of anggBuilding
or a@emtion on same w(thM art
g and Safely, City of Costa Mesa
The ste ping of this plan and spedficafiuns SHALL
or to began approval Of the violation of anProvisions of an NOT be CM to Cc
Mesa Ori; lance and/or State law. y any Ity, of Co
These c and permit shall expire by limitation and become nug and vuh
th..g or work is not commenced
(dand maintained active per UBC §3
) within 180 days Of iSSLa3,)Co.
_ _
STREET
Pa lot-
I131y
1 APPROVED
CITY OF COSTA MESA
PLANNMi DEPT.
SEE DE ILS OtL'B.��sfiRsika, Y!4
ROOF
26 GA. G. I. FLASHING
WOOD FLOOR
CONSTRUCTION
SIDE ELEVATION
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PIERS 12° SOJA o
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26 GA. G. I. FLASHING
WOOD FLOOR
CONSTRUCTION
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23.
HOMES VALLEY, INC.
JOB ADDRESS
W ARM
Dike &
LOT"TRACT
DATE 6-16
BUILDING PI
NO.
w
VALUE $ 15,571'.00
FIRE ZONE DESCRIPTION OF WORK Res. 14/att.gar.
INSPECTIONS L�7D-,�.
DATE
GROUP I & J TYPE V ZONE R1
Underground Soil 411:5 U.G. Water/Y}i$
-I
7-/ -S
SUBCONTRACTOR
PERMITS
ISSUED__
Underground Gas
_
_DATE
---
NUMBER
Overhead Water and_ Gas
Rough Heating---._,/j-S
Rough Plumbing --
�`J%�T.
g=� -
�_ _— 2-f
_r�tj
- =-�-�
moi_
rOTC_
Miscellaneous ,. _
Prop_Swr. ine- FTlotlSe[C_on. SG Swr.
! �<1
Sprinkling System
Heating, Final
PlumbingFixtures p
Final Gas Test?3-
Construction Pole
Underground Power
Rough Wiring.
Trenches' -P-Forms ✓ Steel
Floor Sys
Steel Reinforce Chimney Re Rod
Bond Beam
_
Sheathing /"
&-. 7 -
Frame and Flashing . p�,Gj2
5- I - 7
Lathing, In /( Out
-- S - -
Plaster, brown coat e e 9
/U' - -I -
_
Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final
OCCUPANCY
Form 210-3M-4-59
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA, CALIFORNIA
fOR OPUMNT t0 f/LL /N COMPLETELY
TYPZ OR PRINT
ADDRDESS 2905 Royal Palm Dr.
COSTA MESA, CALIFORNIA
OWNER Homes Vallev. Inc.
MAIL
ADDRESS 4µ9 E• 17th St,
CITY Costa Mesa nn�� TNO:I:TSll59
ARC -CT Carlson & LIC. -
OR VEER ._ NO.
ADDRESS Garden Grove
CONTD CkeeR& Colegrove, Incl CT NO. 167293
ADDRESS 419 E.l th St .# Costa Me -L
LEGAL LOT 7 I 28
O E.C.IFTION NO. 2 1 BLOCK TRACT
A. P. NO.
SIZE 60 YI{ BLDOS.
OF LNOWOON
LOT none
USEOF
EXISTING BLDG.
SETBACK LINE FROM
CENTER OF STREET I REAR YARD I
SIDE YARD ILEFT 51 (RIGHT 51
DESCRIPTION OF WORK
NEV Il( IIALTERATIONI ADDITION
REPAIR I II MOVING I DEMOLISH
BUILDINGNO. OF
SIZE 1560 ROOMS 7 STORIES 1
EXTERIOR VlAJTiUCCO ROOF
COVERING COVERING Rock
USE OF BUILDING AND WORK TO BE PERFORMED
Single family rp-idpncp. with
attached garage.
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CON STRHCTION.
SIGNATURE OF'
PERMITTEE
AUTHORIZED AGENT D'' a RG Cole rove Inc•
JUN 1 a ts;sl
FINANCE DCH.
APPLICATION FOR PERMIT
BUILDING
fOR Off/CE USE ONLY
RECEIPT NO. PERMIT NO�/
�� /-1
ECEIVED BY DATERE� J� DATE 1$SUEq-
BUILDING
ADDRESS
COSTA
MESA. CALIFORNIA
FIRE
ZONE
APPROVED
BY
DATE
ZONING
ZONE
I NO. OF
PLANS
I UBE OF NEW /
BUILDING r//
APPROVED
BY
DATE G
YARDS
REQUIRED
EVES
ALLOWED
(CENTER LINE ST.) _
FRONT
FT. IN.
R. SIDE
FT. IN.
L. SIDE j
FT. IN.
REAR
FT. IN.
THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
VALUATION
$ 15,571
sp
PERMIT FEE
PLAN CHECK
TOTAL FEE $ '