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HomeMy WebLinkAbout1109 SALINAS AVE - Building Permits S' CITY OF COSTA MESA ?jai:@@ BUILDING DIVISION • •,,, . DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �t /.� • PERMIT "_�... /B01-01626 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1109 SALINAS AV Status: ISSUED Suite: Applied: 10/15/2001 Vicinity: HOUSE&ATTACHED GARAGE Issued: 10/15/2001 Parcel Number: 41210405 Zoning: R1 R1 Applicant: ALLEN, TODD ISSUED BY: • Address: 1387 GALWAY LN , - . Phone: (949)675-6705 - . COSTA MESA;CA Zip: 92626 -, i ,_ A Owner: BAERRAMA; BRUNO L-D Address 1109 SALINAS AVE - -- _ /COSTA MESA;CA: Zip: 92626 Contractor: ' TODD ALLEN CONSTRUCTION Address: 1387 GALWAY LN Phone: (949)675-6705 COSTA MESA, CA , - Zip: ., 92626' License:- 698984 .. - - - - Arch : .. Eng: - Address: , Address:- . - -- - /- - Phone: - Phone: Zip: License: - -License: SCOPE OF PERMIT REROOF EXISTING 2-STORY SINGLE FAMILY RESIDENCE&ATTACHED GARAGE,(23 SQ).TEAR OFF EXISTING WOOD SHINGLES&RESHEATH WITH 7/16"OSB. INSTALL 30#FELT UNDERLAYMENT&REROOF WITH 30-YEAR COMPOSITION • r ' SHINGLES. FEE SUMMARY/ - _ • Plan Check: $0.00 - Calc Valuation: - r $5,000.00 Permit: $111.25 Claim Valuation: - $5,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 . , Inspection: $9.00 • • Total: $111.75 ' 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: • 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(WOO) . DECLARATIONS C C WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O 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. -7>p_-1h-ave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Ins ce cannier f nd policy number are: Carrier: "Z .! , Policy Number:--"./Cl 4 'x'9L7/ '(This section need not be completed if the permit/s valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is iss ••,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I shou•beco• :'.eject to the workers'compensation provisions of Section 3700 of the Labor Code.I shall forthwith comply.wiihthese provisions. _Applicant Sipnatur' •._ _ Date: 9q/ Q/ WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL S AND CIVIL RNES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that l'am licensed under revisions of Chapter 9(commencing with Section 7000)of Division 3 of.the Busigess and Projessi Code,andAy license is in full force and effect.Lia •• y // Class'k✓ Contractors.Sig re:- _ v__moi— Da te:�. Io/ J 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: 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:My 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 pemx 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.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.). O 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 properly 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 driver's license. 0 Yes 0 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(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 ❑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? 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 Quality Management District or from any other air pollution control district or agency? 01 0 Yes 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 part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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? ❑Yes ❑No 8 (If'lyes",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 inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. - • =•:esmer(s) gate •nd/O 'lith /-7;-App' .n. , L-Date y CODE t INSPECTIONTYPE 126.1E INTJALS CODE it INSPECTION TYPE 267E 1t�6Lfl 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final � _ 206 Final Plumbing 200 Final Re-Roof /0 `G7pp-0( a"r" 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 APPLICATION FOR A BUILDING PERMIT / BUILDING PERMIT NO. Electrical CO / Tract j,4s 39 Block Lot 5Permit No- c a Building PlumbinPermit No. um Address /( / Cross 5���/ (l Met - cal a Area Street It No0. - ��� o Owner E N,3 6 r]1—� Pr}t'k<� Type of Project: New ❑ Alter If Addition • LOCI S�L4 .(,ars kv ❑ Repair ❑ Conve ❑Demo ❑ Occupancy Pmt. Address 1. I f4J r ]V `/-^�- /^� `�� Sup.Dist./ City "'ZB- Me:541 QQ' zip T2 24 Phone 17-C7_to A.P. Insp.Area Architect! Zone SPI. Pmt.No. Designer License No. Setbacks P/L Front C/L St. Street Width Address Yards Left Right_ Rear City Zip Phone • Eave Prot. Left Ight F.P. Engineer License No. OParKIn9 Spaces Require r r'vide I Located aAddress to Struct No.of No.of M City Zip Phone Height Stories , . . Family O LICENSED CONTRACTOR'S DECLARATION Park Fees ( I Yes Fee ea • Required o No C.T. Receipt a I •hereby affirm that I am licensed under provisions of Chapter 9 t (commencing with Section 7000 of Division 3 of the Business and Zoning Approved By: Date Professions Code,and my license is in full force and effect/. License Class License Number _T Date Contractor Misc. E Address Proposed Use of Structure jL City and Zip Phone H CONSTRUCTION LENDING AGENCY to I hereby affirm that there is a construction lending agency for the - 1 e 1 Class Cons . Yearr performance of the work for which this permit is issued (Sec. 3097, OccCone Yea Civ.C.). Clas y Lender's Name USE/OCCU'ANCV SIZE SQ.FT. C Lender's Address - OWNER-BUILDER DECLARATION y1. I hereby affirm that I am exempt from the Contractor's License Law O lit the following reason: I, as owner of the property, or my employees with wages as their 2. E sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with 3 _ licensed contractors to construct the project. ✓ 0 am exempt under Sec. , B&PC for this reason 4' 0 a Date Owner E WORKERS'COMPENSATION DECLARATION Total Valuation 8 I hereby affirm that I have a certificate of consent to self-insure, Encroachment Permit Required ❑ 'S El No or a certificate of Workers' Compensation Insurance, or a certified - E copy thereof. Grading Pmt. ,--, G -ding 8Policy No _Company Required Yes ❑No P t. No. . 0 Certified is a copy hereby furnished. Rough Grading C ❑ Certified copy is filed with Orange County, EMA, Approved by: Date As Date Applicant B CERTIFICATE OF EXEMPTION FROM WORKERS'COMPENSATION INSURANCE - Z (This section need not be com�����oPPPle -d if permit is for $100 or less). I certify that in the performa it$'e work for which this permit is r 3 issued, I shall n t employ an per n gy manner so as to become n subject/,to he 15ers'Compe do a, California. PE- IT FEES I Oat (2' I Applicant ' g ' ' NOTICE TO APPLICANT: If after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such Electrical $ Special Invest. provisions or this permit shall be deemed revoked. Invest. I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE plumbing $ THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RE • ING TO c ILDING CONSTRUCTION,AND HEREBY AUTH- Mechanical $ O' •E REPR••ENTATIVES OF THIS COUNTY TO ENTER UPON T ABOVE ENTIONED PROPERTY FOR INSPEQQQTION PUR- pre-Grade PsS: . .i. 0 t ()-fjp/ Inspection $ S' a are of A lice nt or Pre-Grade Permitp Agent Date Rec.No. $ Issue $ l--)2Jr34 F2e-iR rhA PlanIssuance ;All spaces within this box must be completed to process — Check71/(4 By: � ' ' ed: CMF 0335-46(BU-28)rev.6/80 CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. lfj`�3,7 DATE 14,171% LOT NO. c7 ADDRESS /02,2 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) (was or were) ,///(A/31„. advised that this tract has not been given f nal inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. BY AsG Purchaser RECEIVED Clf't nF CncT• Developer and/or authorized N O V 7 1972 representative AM PM 7i8NUi11i.1i1i2i3i41516 BY A Lender OWNER BRUNO BALDERRAMO DATE 6-12-81 JOB ADDRESS 1109 Salinas Ave. BUILDING PERMIT NO. 52001 GENERAL CONTRACTOR Owner/Buil der DESCRIPTION of WORK B10Cfwal l 412-104-05 LOT 5 TRACT 6639 FIRE ZONE VALUES 1,200.00 L. cCTIONS - Signa Date TYPE V-IV GROUP N ZONE R1 SOIL PERMITS ISSL ED GAS SUBCONTRACTOR Dote Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE rI HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 5 • ROUGH WIRING / ) Heating and Vent. TRENCHES [Ti FORMS STEEL REINF. I) 5 1.G ,1µj-c( x F 1 R E D FLOOR SYSTEM r S BOND BEAM I, STEEL REINFORCE 7 IRLUtnPle' P' , SHEATHING I C • Sig FRAME AND FLASHING LATHING — IN El OUT Date t� PL•`TER. BROWN COAT 5 URAL, FINAL Electric Ht....NG. VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST in ELECTRIC. FINAL BUILDING, FINAL 06/Gi 1-8-8) • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOrsTRUeTUi2A3,PERMIT 34.: 3 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 - REC EI V °BY PERMIT For Applicant topFill �iinnn Completely — Use Ink Only / / ' ,/0a 00/ BUILDING i ( I V��pi�S we c(A A.P. NO. .z � /O4 c5 ADDRESS �'�/ 1 � 0WNER 2 p�'�.' BUILDING q t� /'( 1, TTENANTOR b2J rS0 {,� P--tom'.-•wy•-vf} ADDRESS //o/ BLlllvh3 �VC� `,,-`• UNIT OR ' MAI ADDRESS ' 19T.ts � Pre a SPACE NO. - /� /� G (/, TR./ryO. pG LOT S ,ELK. CITY ' STB- I" Q • NOL 17CI-�cl• ve�J I. NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION ` .. LENDER //1(` BRANCH QQ OWNER R LI -2t7SD PTt-20tMq ADDRESS VALUE n,., ARCHITECT TEL. USE Fe/VLL•r—. - VQ OR ENGINEER NO P //A ADDRESS ZONE /� I TYP VGROUP /�i CONTRACTOR O //2 BYAPPROVED/ DATE 6/22729( ADDRESS - TEL. - • /� CITY NO. F STATE CITY APPROVED SETBACKS LIC.NO. LIC. NO. (FROM C/L STREET) har O. SIZE OF LOT I NO.OF BLOCS. NOW ON LOT FRONT FT. QUSE OF t „U) EXISTING BLDG. R SIDE/ • ,• .f • Yi FSeparate permits are required for L.SIDE v FT. Ci electric,plumbing and heating work: _REAR FT. _ I.4 USE OF BUILDING AND WORK-TO BE PERFORMED PLANNING ACTION -C • Pzi O /�^�^ DATE / e,,--L L(]C�W�"�--L APPROVED '�� �{/- p >, c .--O//f47 1 FYON-- �Y APPROVEDcF '�..J�[/ _ DATE -/Z'Com/ V.1) o • I hereby acknowledge that I have read this application and state a that the above information is correct and agree to comply with Ar all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of Sthe State of California. /^ °C7 I hereby certify that I am properly licensed as a contractor under SO. FT. L the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force'and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from provision2f the State of California Business and Professions de, Diwsl• Chapter 9. VALUATION 'I PERMIT FEE $ .2.15 ,5 (] 11 Signature of '/�� PLAN CHECK $ 13. 3 Z permittee ,- , /r./I y�L I'— $12OO. TAX $ 0 • S- Authorized Agent Date TOTAL PAID $3 y .5 2 OWNER BRUNO BALDERRAMS DATE 6-12-81 JOB ADDRESS 1 ing Sal inac AVP BUILDING PERMIT NO. 52004 GENERAL CONTRACTOR Owner/Builder DESCRIPTION of WORK Retaining wall & Blockwall 'O. 412-104-05 LOT 5 TRACT 6639 FIRE ZONE VALUES 1,040.00 II ECTIONS Signature Date TYPE V—IV GROUP N ZONE R-1 SOIL PESMITS ISS44ED GAS SUBCONTRACTOR Date Number amba. I Sian WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE El HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND fl POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES iJ FORMS STEEL REINF. r5 .4 A X P I N E. U- FLOOR SYSTEM ' I 1-[tions BONO BEAM [1 STEEL REINFORCE 11 1 (� . .:I SHEATHING twA FRAME AND FLASHING LATHING — IN El OUT ^ P_LACTER. BROWN COAT S (URAL, FINAL Electric HE...'NG. VENT., REFRIG. AND A,C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC. FINAL �/ O BUILDING, FINAL P5/14. • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED B,�/ PERMIT Irrr.i .il For Applicant to Fill in Completely — Use Ink Only a �a��'7' ,BUILDING h o? \�/4� C t- • ' A.P. NO. /02 — l D�.�e,s ADDRESS / V 1V` /�O 5 � des A�� /� BUILDING OWNEROR €R-()a� „ y ^,�^^ .M� ADDRESS TENANT Jw "'fin-•KFR MAI LING PSIS A 'UNIT OR r ADDRESS A')cLE- �S rS L. TR. NO. LOT s-- CITY YOLK. TECITY NO. 1'?-O-k "T003 ' CONSTRUCTION NEW I ADD ALTER REPAIR MOVING DEMOLISH LENDER )<' BRANCH ��, �^�- �-,^, '- "_"- OWNER n-L-apearIn Jy ADDRESS lefos' VALUE ARCHITECT TEL. USE L_ $4,414 ENGINEEROR N ADDRESSZONE PE /��}j I /Li(3ROUP Al APPROVED / 2 er/ CONTRACTOR 06 BY DATE/C ADDRESS TEL. CITY NO. - • i-iF^ STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE ANO.OF BLOCS. (FROM C/L STREET) O. OF LOT . NOW ON LOT FRONT FT. 'A Q USE OF Ca EXISTING BLDG. - _EL SIDE 'LW.' . V3 er �5 Separate permits are required for L.SIDE electric,plumbing and heating work: REAR FT. W US OF BUILDING AND WORK TO B PERFORMED PLANNING ACTION F UJ s t-E_. t , nQ -�(fTi rJIBfC I 4.0-.611.1 rasp Q � LV_` DATE ,:r.U sY-�Tp I cr. ��� OAPPROVED } APPROVEDQ 6 1- ,�2 me` / -ADATE C4 EY . . 0 I hereby acknowledge that I have read this application and state E4 that the above information is correct and agree to comply with E. all laws regulating building construction, and I shall not employ ` WZ any person in violation of the workman's compensation laws of ,, the State of California. / I hereby certify that I am properly licensed as a contractor under r� O > 'a66 . FT. . tO�D- — i • the State of California Business and Professions Code,.Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR i Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: • am exempt fro the provisi of the State of California Business VALUATION PERMIT FEE $ . and Professio ode, Divisi 3, Chapter 9, Q /� CO ) i-PLAN CHECK $ /et, cS Signature of ((/�pII / • • PermitteTAX $ 1� ^'�Of c Il /P-/ .� $ /�1 �O TOTAL PAID $`3/ 8751 Authorized Agent Date I -�1! OWNER . BALDERAMA,_ Bruno DATE 7-3-73 `JOB ADDRESS 1109 Sal.inas Avenue BUILDING PERMIT NO. 36901 4(' 'RAL CONTRACTOR owner-builder DESCRIPTION of WORK Patin Cover k 412-104-05 LOT 5 TRACT 6639 FIRE ZONE VALUE $ 1000.00 INSPECTIONS Signature Date GROUP J TYPE V ZONE R1 /jSOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number I Signature A‘WATER Plumbing ROUGH PLUMBING PROP. $WR. LINE ❑ HOUSE CON. El SPRINKLING SYSTEM MISCELLANEOUS � ROUHE GH ATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING �p�,./ Heating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. ❑ f r�\ 7-lt',�i FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LAT' 'NG — IN n OUT n PI R, BROWN COAT STh....TURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ❑ ELECTRIC, FINAL _ • PAIL) 10.50 K 36901 JUL 3 73cnsao� 194 **** 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 RECEIVED DATE ISSUED BUILDING 1109 S ate% VEL 3 7 73 ADDREStao f:::, p� [VVJ I\1��� � / '1 /—ar�OWNER iJa t1��rL� A A.P. NO:-Ifa /Oq -oS PE[imj-LNo1 BUILDING p j(` /� MAIL ADDRESS /f 0� SAL( N f] S A UE_ ADDRESS q W W ( al241-5- TEL • p TRACT �� / LOTS BLOCK F-Z CITY C6•s'•"ce. Mc<sk NO.q7r^� z C CONSTRUCTION NEW J [ALTER REPAIR (MOVING OFMOIISH O-N LENDER d m J 7 BRANCH T COJw ADDRESS OWNER 8,ett L✓p-e cp yyt/�� •m ARCHITECT • TEL. USE `ArT3Q l_' e — SAM J < OR ENGINEER -NO. OQ FIRE th LLI ���/z� ZZONE TYPEi ST GROUP t-T z X ADDRESS n a Uri F� - APPROV r J-�� J O CONTRACTOR �JL',)N`LP. `�I 4-704.4.. . - BY DATE? J 7Jcr ADDRESS 0 iee#41 t/NEAJCG.iJ1£O 0 w TEL. Z H ZONE n NO.OF USE OF NEW 1- CITY NO. K( PLANS ea BUILDING ✓,SC _ W O STATE ' CITY YARDS APPROVED YARDS APPROVED rn 2 LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BU DING 0O — (FROMC/L R E SIZE NO.OF BLDGS. OF LOT NOW ON LOT FRONT - . USE OF EXISTING BLDG. R.S 3 FT- . E SIZE OF NO.OF • �1 / r/ Z NEW BLDG. ROOMS STORIES L.SIDE K-7 FT.`_ FT. VEXTERIOR WALL ROOF if COVERING _COVERING REAR S.FT.7 FT. J US OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0. '� (O �C+V�LZ Qa MAIN BLDGS. ACCESS. BLDGS. Q _ VAR.# DATE O gLS 4c c �� � C.V.P.# APPROVED I— APPROVED ) /f` N a CO -AP 60_'j/ 2 0 FI hereby acknowledge that I have read this application and state r D that the above information is correct and agree to comply with r.I Sp all laws regulating building construction, and I shall not employ Ki CC I- any person in violation of the workman's compensation laws of N the State of Ca'_•rnia. m Z SO. FT. u) I hereby c. ify that I . properly licensed as a contractor under i 2 I the stare o Californi. B.siness and Professions Code, Division 3, HE AMOUNT SHOWN UNDER VALUATION IS FOR g Chapter =, a • that s ch ses are in full force and effect,or I THE PURPOSE•OF ESTABLISHING A PERMIT FEE ONLY: e am axe •t ft the •rovis •ns of the State of California Business — 2 and Profe-sioQs .one, Divisi VALUATION /0 0_0 N PERMIT FEE $ . Signature o � pt 1 Permittee __ 78-in -in PLAN CHECK $ E U V// f] Authorized Ag nt / - TOTAL FEE $ /1/ LL OWNER HELTZER Enterprises C osta Mesa DATE 2-8-72 JOB ADDRESS 1109 Salinas Avenue BUILDING PERMIT NO. 34318 GFNERAL CONTRACTOR George J. Hel.tzer DESCRIPTION of WORK peg w/n++ gar ). LOT 5 TRACT 6639 FIRE ZONE VALUE $ R5 000 00 II._.-ECTIONS Si•nature Date GROUP I&J TYPE ZONE ;- SOIL dAr -arr75r`1 SUBCONTRACTOR PERMITS ISSUED GAS Date Number Si.nature WATER Plum•in• ROUGH PLUMBING „ s i� s� W , lbQ`,�i 40 / r PROP. SWR. LINE HOUSE CON. © G , ,.,ro. O, , ,I na - /���/ -/' J SPRINKLING SYSTEM "UJ MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING 6 8,77/ TEMPORARY SERVICE OR POLE UNDERGROUND fl POWER fl ROUGH WIRING A'A`���� yL r 'Heatin. and ent.i TRENCHES I' FORMS STEEL RE INF. %��L�/i/1Z// l ,L_.„a � ���` FLOOR SYSTEM w 'Yf0%/ �//// /Tf�/'MW ��I� //%t BOND BEAM IN STEEL REINFORCE Lr�� SHEATHING Oi��V)O FRAME AND FLASHING ie� r -- LATHING — IN OUT e > P" -ER, BROWN COAT ie.-4,-w_ L4�/ e. allinli. HEATING.I FINAL REFRIO. AND A.C., FINAL / / 1 le t�.' �. c > yf`�6 �-"�z, ' f�/G�i'7/_�i7.Y��JG'?lE�4l�X�y�— PLUMBING, FINAL AND GAS TEST f x/a�, . t0-L3.2'2— �� ELECTRIC, FINAL / 1'043-72-- BUILDING. FINALA' /a./y?-7'L_ 34 I I S n PAID CB COSTA MESA BUILDING-SAFETY DEPARTMENT 7--- OO 310* **lei 71.00 P.O,BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RE I\ ED Y DATE RECEIVED DATE ISSUED BUILDINGBUILDING / /2 -3--7) ,,-4J7,7 ADDRESS 1109 Salinas Ave CnsYS Mesa' PERMIT NO. OWNER Heltzer Enterprises-Costa Mesa A.P• ND• MAIL BUILDING ADDRESS 740 N. La Brea Avenue ADDRESS, /,//�/9 S ` 0 0 CITY Los Angeles, CA 90038 NO. 937-217 TRACT(G 6� , LOT BLOCK zZ •• ' REPAIR MOVING fEMOI ISH I CONSTRUCTION United California Bank Oco LENDER j co BRANCH Main Branch 600 South Spring St. v mIll ADDRESS Los Angeles, CA 90054 rr in VALUE m ARCHITECT ' TE LW?. 3- /�' OWNER •• $ 3_ VDO' J < OR ENGINEER David Freedman AIA ND, 3852 U Q FIRE T w X 'ADDRESS 113 N. San Vicente, Suite 306 ZONE TYPE GROUP + a w Beverly Hills, CA APPROVED J Z CONTRACTOR George J. Heltzer BY _ DATE CO Z • n� :I Ir ADDRESS 740 N. La Brea Avenue �Y`", 6'i " W W TEL. Z INO.OF USE OF NE Z CITY. Los Angeles, CA 90038 NO. 937-2171 P ^"s 3" BUILDING STATE CITY YARDS APPROVED YARDS APPR ED NIL LIC. NO. 3144 LIC.NO. 1900 MAIN BUILDING ACCESSORY BUILDING D O r (FROM C/L STREET)SIZE N /7 OF LOT I NOW ON LOS FRONT Q FT. Y /1 FT. USE OF ` EXISTING BLDG. R.SIDE 1 0 FT. FT. I— SIZE OF NO,OF ��j Z NEW BLDG.' ROOMS STORIES L.SIDE 7FT. FT. - oEXTERIOR WALL ROOF l _ _COVERING COVERING REAR J � FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1 a GSMAIN BLD . ACCESS. BLDGS. Q VAR.# DATE O PPCi denrP With a ttanhed •arag.P , C.U.P,# APPROVED N Plan #407 APP ROVED (��� JOATE /w(2 OQ'41 o VE I hereby acknowledge that I have read this application and state HOLD FOR $PECII4L REQUIREMEIP that the above information is correct and agree to comply with ¢ all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. m ZO CO I hereby certify that I am properly licensed as a contractor under SO, FT.496 o the State of California Business anc Professions Code, Division 3, THE AMOUNT SHOWN UNDER ALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from the pro 'snores of the State of California Business VALUATION and Professions Code, D I on 3,Ch ter . i/ &t N PERMIT FEE $// Signature of .l it m Permittee -. $ •� \ PLAN CHECK $ s7i E Authorized Agent �r TOTAL FEE $ LLSte/7/1/