Loading...
HomeMy WebLinkAbout2737 SAN CARLOS LN - Building Permits 1111 i CITY OF COSTA MESA O pa,(J. ; • BUILDING DIVISION i kmer.ms.. 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us r:. FOR INSPECTIONS CALL: (714)754-5626 Its"'°""° PERMIT NUMBER: BC10-00245 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 07/22/2010 ISSUED BY: RMD JOB ADDRESS: - 2-737 SANG RL"OS-LN=CM- Suite/Unit: APN: 14155706 Zoning:R1, , Vicinity: Primary Occ: Const Type: V-B SQ. FT: - • 484 Valuation: $80,000.00 SCOPE OF WORK: ADD 357 SQ FT TO EXTEND MASTER BEDROOM AND REMODEL MASTER BATH. NO ADDITIONAL BEDROOMS OR BATHS.ALTER/REPAIR COOLING/HEAT, 1 VENT FAN, 13 LIGHT FIXTS 10 OUTLETS,6 SWITCHES, 1 BATH TUB, 1 SHOWER, 2 WASH BASIN, 1 WATER CLOSET. OWNER: KELLY, KIRK Address: 2737 SAN CARLOS LN Unit: Phone: 714-791-0984 City/State/Zip: COSTA MESA,CA APPLICANT: KELLY, KIRK Address: Unit: : Phone: 714-791-0984 City/State/zZip: CONTRACTOR OWNER-BUILDER License No. 000000 Phone: Address: Unit: Cell: City/State: ZipCode ARCHITECT: - License No. PHONE:. ENGINEER: MOHAMMAD NAMVAR-NAVMAR AND ASSOC . License No.C39797 PHONE:310-540-7788 COMBINATION PERMIT FEE SUMMARY Building Plan Check: $554.94 Building Fees: $853.75 Electrical Fees: $0.00 Mechanical Fees: $44.45 • Plumbing Fees: $0.00 SMIP Residential: $8.00 SMIP Commercial: $0.00 Bldg Std Admin Fund $4.00 TOTAL FEES: $1,465.14 —Refer to fee receipts for all fees paid for project HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010=, PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibited all hours-Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day,Labor Day,Thanksgiving Day and Christmas Day 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. CODE r. INSPECTION TYPE DATE INTITIALS CODE# INSPECTION TYPE DATE INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical X M-/9-// MO cO.i 1266 Pool Spa Final 208 Final Plumbing N-/9xlnPA9 200 Final Re-Roof 210 Final Electrical —1 4-m nu'ASL.. 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 4/'/� 204 Final Demolition 250 Final Building/Occupancy X At-/9-// me i WORKERS'COMPENSATION DECLARATION: Owner ID verified by`driver's license. 0 Yes ❑No �}-� �7 I hereby atm udder penalty of perjury one of the following declarations: DrTivers.6icense•No. �- ``pwbS' /a 1 � 3 ❑ I have and will maintain a certificate of consent to self-Insure for workers' `erific�Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy 0 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,scaffdding,falsework,a demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This seriion need not be completed rf the perme is valued at one hundred dollars($t00)or less) 2,Art 2,Sec. 341,Title B,California Administrative Code). • Poky Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance . e 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 pers.• any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation • of California. and agree that if I should become subject to the wor - s' compensation provisions of Section 3700 of the Labor Code,I shall f. with comply with these provisions. Applicant's signature Date Division of Industrial Safety Permit Number: 'p`cant's Signature` .Dat` e> HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARN! G: 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? 0 Yes 0 No ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the Califomia 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 pr. ' ions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of t.' =usiness and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and eft: . a registration form for acutely hazardous materials? ❑Yes 0 No [L-ic:f'r 'Qfass'N- (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 _.r..: . ignature Date- 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 CO• TRUCTION 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 ❑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 Date 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 ❑ 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? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment 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 hundred 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 compensation, 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? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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 ❑�� as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. CLICENSED 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 0 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 an. Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purpos . I agree not to occupy or allow occupancy of any building authorized by thi permit until final inspection. S/1' - ` S I w a �t Owner(s) /Date 0 4 ✓' Signa e Dat /aj 3051-46(3107) Andor== • 1_ ., . >, , c City of Costa 9Ylesa Bui&[ing Division Costa Mesa 77 Fair Drive, Costa Mesa, CA 92626 714-754-5273 / Fax 714-754-4856 OWNER BUILDER VERIFICATION;� Permit # 3(10-001' 1 Disclosures & Forms for Owner- Builders Applying for Construction Permits IMPORTANT! NOTICE TO PROPERTY OWNER Dear Property Owner: An application for a building permit has been subnit�ed in your name listing yourself as the builder of the property improvements specified at '1,-' &on 0ar(n'' bvi t . We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. 1r __Lim I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner- Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. . I understand building permits are not required to be signed by property owners unless they are reslposible for the construction and are not hiring a licensed Contractor to assume this responsibility. =-n3�I understand as an "Owner-Builder" am the responsible party of record on the permit. I understand that ay protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his or her name instead of my own. \.-r-- 4,>j understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. \2„,,,: t1 understand if I employ or otherwise engage any persons, other than California licensed Contractors, and thtotal value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. \216_ 1 understand if I am considered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. 4 7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building Contractor. 3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2 GIP �sAL48.1 understand as an Owner-Builder if I sell the property for which this permit is issued, I may tie Held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. �It72.-4O. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: 1 I.agree that, as the party legally and financially responsible for this proposed construction activity, I will a ide by all applicable laws and requirements that govern Owner-Builders as well as employers. �121 agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this f m must be completed and signed by the property owner and returned to the agency responsible issuing the permit. Note: A copy of the property owner's driver's license, form notarization, o ther verification acceptable to the agency is required to be presented when the permitis ssue o verif the property owner's signature. Signature-- :of-property owner //�e CDa 7/ I Q Note: The following Authorization Form is required to be completed by the property owner only when designating an agent of the property owner to apply for a construction permit for the Owner-Builder. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work): Project Location or Address: Name of Authorized Agent: _ Tel No Address of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Note:A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the property owner's signature. Property Owner's Signature: Date: 3148-30 CALBO Jan 1, 2009 OB Packet template 2 of 2 -*.rsy5c�wu:.,n:.».:;✓..:.L.;.ry'+-""'+...->�..i... r v`.,. "Ar't-\ •'r„•,ar _ .� -y-'ri`VD.'- r"'%,` y • r•;4�'r� Date 1.1. 0 to 931" fi "a cltyof costa `M2So ."' )OClo'x CIS 114 -q11 - � � 01 `' Permit. iC - fir SPECIAL INSPECTION REPORT Project Name: ..KQ,\ F ',�• Ae..ir ^ Project Address: �L 1 y ('(L "1 Sc..,v C_0,...-\ns LV1 Phone: Owners Name/Address: Phone: General Contractor/Address: S\r,p(„)C 0.SQ Cron.re kit 3\0- S b3 .1 R1� _Phone: ' Sub-Contractor/Address: Phone: ` (� Engineer/Address: O,srn o o x' A SSC C 3\0- 540 -1188 Phone: t'd. cot TYPE OF INSPECTION O WELDING \ 4 $.EPDXY ✓] GUNITE O STRUCTURAL STEEL ASSEMBLY f= OTHER O REINFORCED CONCRETE O H.S.BOLTS O N.O.T. O PRESTRESSED CONCRETE C MASONRY O FIREPROOFING O SHOTCRETE O SOILS • • WELDERS-LIC.e-EXP.DATE ' SUMMARY OF WORK INStvt. INSPECTED p "` '�Tr t Io ssev- seA ' `Or ee - nT y '1••-tcl r\o uJe\ S 4 C - C- /sk .,,.{ sA.cz\o dot eJ S qs c.e /s1 • Pio\ rec OA- tie \Ornuy �c ec d6, �\ � zo%u . 04'kse% tee( CO\ e \ra°(` vvw..t2-s @ C., - a C pe' n 1c o'& cd e\-c, ; o� Gt�./ r ver� ��na� c.`ec.vl -0 k- t ,)/ C•ow►pv-e cse ra%ncS. IA )• ve \nvcvc\-, -"-\n-- -k-n \\okCe.Vs')n$ • • • HOURS DATE • REG. O.T. TIME IN TIME OUT S/10/11---C, • 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 halt. 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 lees, cost and necessary disbursements in addition to any other relief to which such party may be entitled. tn�,,� CERTIFICATE OF COMPLIANCE /+ I Inspector Name: Gee.) t t41S Inspector's Signature: I.D. NO. SaS 3'1 i.- LI q has been filed and it.states that the ab. •.work to the best of his/her knowledge complies with the provisions of the Building Code and meets Approved Plans and Specification. • Approved by Respectfully Submitted By '/11, Superintendent .111 CITY OF COSTA MESA 111110 ' BUILDING DIVISION ' • y ,ll 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us TA. Ira f FOR INSPECTIONS CALL:(714)754-5626 • PERMIT NUMBER: BC09-00009 PERMIT TYPE: . B_COMBO STATUS: ISSUED Sub Type: POOLSPA DATE ISSUED: 01/12/2009 ___ISSUED BY: • JOB ADDRESS: 2737 SAN CARLOS=(N CM Sulfe/Unit.: APN: 14155706 Zoning R1, P - `-/' Vicinity: - Primary Occ R73 Const Type: V-B SQ:;FT ,` 80 - Valuation: $12,000.00 • SCOPE OF WORK: CONSTRUCTION OF AN 80SF IN-GROUND SPA :IN AN EXISTING POOL WITH 1 FAU < 100 K BTU, 1 MOTOR TO 1HP,;1_MOTOR TO.3HP, 1 100A SUB PANEL, 1 BACKFLOW PREV;:T`GAS OUTLET(1-4)AND 1 PRIVATE . SPA. - i • OWNER: KELLY, KIRK' I Address x2737 SAN CARLOS LN . ' - Unit: Phone: - 714-791.0984 „ City%State/Zip: COSTA MESA,CA-- - - APPLICANT: OREGEL ISRAEL }3' Address: 4376 AVENUE DE LAS FLORES --:_i Unit : Phone: 714-809.3361 r �.i, City/State/zZip -•YORBALINDA CA'' . , - CONTRACTOR. IZZYTBUILDERS INC License No. 838632'.: _ Phone: 714-809-3361', Address: P 0 BOX 18751 Unit: - ' Cell: I .. ` -.City/State:",'ANAHEIM;CA '-- .,---ZipCode 92886 . ARCHITECT: ^� w License No. - ' PHONE ! ' ENGINEER: TODD L LACHER License No.67656 ' '" .PHONE:714-630-6100 COMBINATION PERMIT FEE SUMMARY`• Building Plan Check: - "���$136 01 -} : ';; ` Building Fees: $209.25 ""� Electrical Fees: . , Mechanical Fees: $3850== ":��' - , Plumbing Fees: :;,,$69.70:: . : SMIP Residential: $1.20 [:� ' SMIP Commercial: Y.$0.00 ' - - • - Bldg Std Admin Fund $9:00^ TOTAL FEES: $518.16 - " `"" --Refer to fee receipts for ell fees paid for project . r • 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. CODE/. INSPECTION TTIN 2_,n INITALS CODE/ INSPECTION TYPE - pATE iNTRIALS 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 ,2-n]Q --`0c Ali" WORKERS'COMPENSATION DECLARA - Owner,ID verified b icense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: . Driver's License No. ' Expires: b I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or.deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 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 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: J // p ,,/ person is required to descend,will be made in connection with work authorized Carrier" S/ey yrh v,ncv by this permit,and that no building structure,scaffolding,falsework,or demolition (This seem need not be competed/the permf is vowed at one hundred dollars or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (Ke? 5//O / 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ❑ I 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 the Labor Code shall fo}hwith co y wit ese provisions. Applicant's Signature Date /��t //� ' � /4, Division of Industrial Safety Permit Number: Appio is Srg ate 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 my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No r Lic.-#—F53�^�G 3 Class#. .. (Section 25533 of the California Health and Safety Code, with some //, exceptions, requires registration with the Costa Mesa Fire Department by ` .0 .«•/1 //y7/Oq each business which at any one time has on hand a quantity of acutely / Corn to gnajul� Date.-„ 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)? ❑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 Date 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 California 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 pan 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? 0 Yes 0 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 hundred dollars($500).): of the California Health and Safety Code). ❑ I. as owner of the properly, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, 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 California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 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 pollutidn 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 pehalty 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 city ordinances regarding Hazardous Materials and Emissions. ❑ 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 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 0 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 authorized by this permit until final inspection. ttega Ovm- -•_ te Signature Date 305746(3/07) :/�If�If!�.� ���:. /1;:74:7r7 •�,% / �.- De n • i Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • 1qo U - - - - - GF1'OF COSTA MESA CONcSTRUCTION:PERMI7 PEGgMITO. JD�/ TRACT NO. LOT NO. _UNIT NO. r, z n- 4,,'. Project Address 2-7 37 ' S�+., c. ,-t l0 S J �? O'Ci/_ • 1 t ' . 3 L. S. � y ...Applicant'sMailing Address `f(.�5�r�2 /3"-Z0111-4.4r) TYPE OF,CONSTRUCTION U NEW Li ADD U ALTERATION L� REPAIR, • 1* • El CONVERSION, ❑DEMOLISH ❑ OTFJER • •Owner's Name J,�l„•r•c 5_ k'c a Phone - _ ke - A.P.# _ •.. . r, - Zone • , _ DESCRIPTION OF WORK/USE OF BLDG. c�!'�''I It SP _ T7� Address /t� C-2055 tri c 'TRV out . . • - S , Main Building: ' - rI ,-. .,Abcesspry'Buld'R�: I - E I -.� • Z ,Arch/Eng. - - License No. • TYPE OF PERMIT' ❑ GRADING '❑ FOUNDATION H STRUCTURAL - T Front • fit [�(� 9 • 0 Address I' ❑..TENANT ❑.ELECTRICAL, ❑ PLUMBING' ❑ MECHANICAL - B Rear l OCT 1 f7`Z _y J - N {� 7 r- Y 13 I jlo.rl,.,r ❑ ,OTHER KC le? - ' A Contractor's Name 126 1J22✓-fv9„e4 SJNS Phone' 0v-,-/ r2f-/ 1 D C Right • er-- -,,,_ , 'r - •; N '..j-� PROJECT DESCRIPTION Sq. FT !2 OCCUPANCY • Address(mailing) KU$0 �a /320 -vr-to--., n //,. - L( r F G CONSTRUCTION TYPERUG•tIN' VALUATION$ Li PC* On • K Left - 1 I�o 'V •-„k City License No. - $ �i1 `�f f' '"r"^ - 'R ZONE • LICENSED CONTRACTOR DECLARATION GRADING CU.YDS. ACRES :Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing 'Remarks: • Planning Notes: • M ' with section 7000)-of Division 3 of the Business and Professions Code, and - • _ T my license is in full force and effect. - , • 3183165 s -License Class L15ense No. , Date l0- ftl -3�$ Signature R�-�-�"%� GF-�_-- PLUMBING ; - FEES- ' • '+ , . : MORKERS'COMPENSATION DECLARATION .i:. I • Bar Sink Showers ' • ELECTRICAL FEES 'b.:ereby affirm that I have a certificate of consent to self-insure or a certificate _ JWorkers' Compensation' Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink - - r 800, Lab. C.) Automatic Washer Transfoimer ❑-15-50 KW- Policy No. • Company Backflow Irrigation • $ewer Ca - • 0 50+ KW P Construction Pole Sub., • I - Certified copy is hereby furnished. - - Certified copy is filed with the city Building Division. • Bathtubs Sewer Connection • Cooking Unit • Meter ❑up to 100 amps Date Applicant • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION 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 f o thatm in the performancepersonin the work for as to this permit is issued,I I _ shall not employ any person in any manner so as to become subject to the - Drinking Fountains Solar Tank . 0 Floor Drains Swimming Pool w/Spa • F.A.U. — Inc Solar 09-15 HP 016-15+ 'NOTICE: If,after making this declaration, you should become subject to the - • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks I. - Urinal - - - - Fixtures - - --, - •- - . - • comply with such provisions or this permit shall be deemed revoked. - Microwave • •• CONSTRUCTION LENDING AG ENCV . - Gas Service Outlets • ' Water Closet •- Device Boxes • I hereby affirm that there is a construction lending agency for the performance • POI¢ Light , • of the work for which this permit is issued (Section 3097 Civ: C.) •Interceptors Water Heater A Y+ Outlets Ran e ' Lender's Name _ p 1P - 9 Lender's Address - Kitchen Sink Water Service` ' Switches , Sign •' OWNER BUILDER DECLARATION - �Q\ ,y g _ - I hereby affirm that I.am exempt from the Contractor's License Law for the Lavatories [[ I , following reason (Section 7031.5 Business and Professional Code: Any city.or Auto-Wash ` \� Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap - Laundry Tra Oysgf� I C �enerator ❑0-5 KW❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit - S yn-'T 7 p ' to file a signed statement that he/she is licensed pursuant to the provisions of. _ la - Roof Drains A - ,_.fhe Contractor's License Law(Chapter 9 (commencing with Section 7000)of \ - ";:j!ivision '3 of the Business and Professions Code) or that he/she is exempt - - - ' r ,0om and the basis for the alleged exemption. Any violation of Section _ • ' _ '::,031.531.5by 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 Reinspection Fee I - $15 orb/Oleo leo Fee ' $'3 •— compensation, will do the work, and the structure is not intended,or offered V 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 own . DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such improvements are•not intended or offered for Boiler Hood O Type I 0 I , sale- If, however, the building or improvement IS Sold within one year of'con- Canopy Type II ❑ • Zoning •Approved By Date Wench',the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date' ' prove for the purpose of sale). - , ❑ I, as owner of the property, am exclusively'contracting with licensed con- Duct-Structural • Refrigeration System ' Application Issued By nate' tractors to 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 00-100,000 BTU 0100,000 BTU • SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with-a con- - - ? so tractor(s)license pursuant to the Contractor's License Law). I am aware that - BUILDING PERMIT $' 701 • G�' SMIP $ _ f Exhaust System 0 Multiple 0 System.Repair/Alteration proof o their Workers compensation insurance should be provided to me. _ • PLAN CHECK $ PERMIT • ❑:I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# _I Fire Dampers PLUMBING $, 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; • 00-100,000 BTU 0100,0006T - - - _ GRADING $. - i information is correct: I agree to comply with all city and county ordinances- ELECTRICAL $ • I and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $' I ' MICROF,ILM, $ - ' , sentatives of this city to enter upon the above-mentioned property for , inspection cos s. I f MECHANICAL $' TOTAL FEE ' $I 347-Or) ,p ./ 6r--��--- • Dat /J`r/o --$'S r Signature Drivers' License or SSI# ) Goldenrod -Assessor • 1 s, CONSTRUCTION AND PLANNING POI SPA- "" .' APPROVALS • Permit# Date Inspector• APPROVALS Permit,l& Date . Inspector 1.cTemporary Electrical Service or Pole 52. Pool & Equipment Location ' 4-- . 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 V ' 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing'i 65. Electrical-Final - ,15. Rough Electrical-Conduit 66. Solar System-Final _ _ _ Y16.{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.iRough Factory Fireplace APPROVALS Permit# . 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil C , 23. Gas Pipe-Rough & Test • - 72. Underground Flush r.24. Roof Framing - - 73. Undergrnd.Storage Tank CIGas 0Oil' 25. Roof Sheathing 74. Overhead Hydro ' 26. T=Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,`-•. ' xr27. Frame and Flashing - 76. Dry Standpipe" .28. Lathing & Siding , 77. FIXED SYSTEM FINAL 29. insulation 78. F,IRE.PREV. FINAL ' 30. Drywall NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FiNAC[INSPECTION • 32. Electrical Power Meter-Final , ` 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Notes: . . . ' 34. Final Heating & Air Conditioning - 35. Final GasPipe-Test • . ' • 36. Hood or'Canopy 37. Final Factory Fireplace 38. Final Plumbing . . 39. Water Service-Final . 40. Gas Service-Final 1 • 41. Solar Domestic-Final 1 42. Backflow Preventer • - 43. Backflow Irrigation - • 44. Landscape Irrigation System - 45. Sound.Attenuation - - . - 46. Handicap Regulations • - . r47. FINAL STRUCTURE & BUILDING - 48. Special Requirements Completed 49. Electric Release to Edison. . ,_ ,• , 50. Ga's Release to Southern California Gas Co t - 51. CERTIFICATE OF OCCUPANCY . No. - - Date. - • I • • • S 10 U4lal �j RECEWEO 1 CM) (!�/7T- o L.A B 0 /R/�, ATO c5iso+ , Jesiiny and inspection L�n7inee r JUL 2 1962 r wfs fes'of Costa Mesa L•• cr•S, Building Dept. I COMPRESSION TEST REPORT v/` ilia -` Test made for Anthohy Pools 4817 Firestone Blvd . , Sout ate '1� Job Identification 273_�N CARLOS LANE Costa Mesa Location in Structure NORTH END OF POOL --- - --- - - - GIINITE — - - - - - - LABORATORY DATA Laboratory Number 49596 • 49597 Mark H-1 H-lA H-1B Date•moulded 5/28 5/28 5/28 • • - Date tested 6/4 6/25. .. 1 L.-, Age,days 7 28 Weight per cu.ft.,lbs. 130 130 Dimensions, (inches) 6.00x11.7 6.00x11.6 .•5.9;5x11,8 Area,sq.in. 28. 27 28.27 27.80 ' Compressive Strength • w 'Total Load lbs. 65,500 110, 500 Lbs.per sq.in. 2 ,317 3,909 Not req'rd FIELD DATA . MIX: Gunite 3 gal/sk. Cement . Perine nente I- 1 pt. Specified Strength @ 28 days2000#' Sand 4-1/2 pts. Slump No.4 Admixture No. 3 - Ready Mix Plant No. 2 . Cyls. made by R. Nugent Water Date cyls. delivered Builders Pickup 5/29/62 • 2- Anthony Pools ///���/ s 6, Respectfully submitted,_ /tMesa /� ` Coe Bldg Dept. f Y•,I�(,i • RAYMOND G. gNE LAORAT ) In CF-3 By /;if �� /1l, 235 WEST TWENTY-SEVENTH STREET • LOS ANGELES 7. CALIFORNIA • RICHMOND 9-3111 .,....uw..� ✓ru•u...+ ✓nIL • - 1 10—14 JOB ADDRESS2737 San Carlos Lane BUILDING PERMIT NO. 37838 GENERAL CONTRACTOR Santa Ana Pert and Awning DESCRIPTION of WORK Add Pat.Cov.to Res. APNo.141-557-06 LOT TRACT FIRE ZONE VALUE $ 510.00 Jr INSPECTIONS Signature Date TYPE IV GROUP J ZONE R1 ASOIL PERMITS ISSMED GAS SUBCONTRACTOR Date I Number Si qn gture WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE IJ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING • TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS 5 STEEL REINF. Q _ FLOOR SYSTBM BOND BEAM L] STEEL REINFORCE I^I SHEATHING FRAME ANO FLASHING LATHING — IN n OUT 5 PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. ANO A.C., FINAL PLUMBING. FINAL ANO GAS TEST n ELECTRIC. FINAL BUILDING, FINAL lif/r. no•7 / SPECIAL REQUIREMENTS �i , y r' PAID { . 37838 1,^.H i6-74PAID 58?_' :rtrt 6.50. '"' COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 P'LI'ATION FOR BUILDING PERMIT For Applicant to Fill in Completely • _ Rp E' :Ne DATE RECEIVE• D TE IS UED BUILDING �1 vi Cocci l / .i /— A ADDRESS 0 7 3 7 SC4 vl \ o c (tis L Vt 1 r� r- prep/y7� OWNER Jn VVl P g KP \ ' p A.P.NO. tLk _SS (—OW Ek /() MAIL J BUILDING /� ADDRESS cSame ADDRESS .2 -23 7 $5yl ! /IY�nS L0 W W n L /y/ TEL., 9 N — TRACT C'r-BS LOTS BLOCK NZ CITY C/76'h 4ptsa NO. QA Si7 Z Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING OFMOI ISH O N LENDER JD BRANCH '/Uii e OWNER nrnRs, ,-p/// ADDRESS a ye /y VALUE �+ J Q ARCHITECT n // / TEL. 7,/J — . USE�C/'.O 1 '/T!I`er $ J 7n OR ENGINEER R ,4/° ccl PV NO. CI. -7 Z Q ,f� FIRE 77WCC ADDRESS anis Id er,,,ba�k el gem ZONE Ei �'YPGROUP a. I-9 / A APPROVE / //,/ JO CONTRACTOR c,n .K/ 7n Tent V."0/f /.�� BY !( DATE/ 4- 77 03 /� Jm ADDRESS as ( t? Sr) //2,0IIBJ Cl- WOW �/ ,/ TEL. b"-/t$ -- ZON\ 1 NO.OF PLANS 2 USEOF FGEW1 .0 Z O CITY Co h 742 .X/h1 cc NO. ()y9/ 1�.\ L:.\�— W STATECITY YARDS APPROVED YARDS APPROVED tom LIC.NO. sCCr / q LIC.NO. MAIN BUILDING _ ACCESSORY BUILDING D O K (FROM C/L STREET) SIZENO.OF BLOCS. ,I�I� OF LOT I NOW ON LOT FRONT FT. ,�{I/ FT. USE OF EXISTING BLDG. s^)"/r rain,', 1S/ res' R SIOF FT C FT. I— SIZE OF q / NO.OF l Z NEW BLDG. /g-1 I ROOMS STORIES I L.SIDE FT. A'( 1 FT. EXTERIOR WALL ROOF V COVERING COVERING .>� REAR FT. CO FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 110 MAIN BLDGS. ACCESS.BLDG$. r VAR.# DATE o Y/ /J(2/ �1 ,[7?M ,4/U 712, Lgt kr/ C.U.P.# APPROVED /� y� //'� /' APPROVECt.'% r z /va976 l fOue/ Jn� coJI7 _BV `�� _DATE \-1b�1 O • U' I hereby acknowledge that I have read this application and state • othat the above information is correct and agree to comply withCC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of the State of California. muI hereby certify that I am properly licensed as a contractor under /FlySO. FT. p the State of California Business and Professions Code, Divisicn 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 EE ONLY; m am exempt from the provisions of the State of California Business Q and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ '— N D Signature of ^ //,/Jt,,' /�/j� ��/� E Permittee .].®� Cf/G(�L� I.I C.I�v`" $ L // 0� PLAN CHECK E DD d C/ / o Authorized Agent AiLZ/ ' 7 i �')! u "✓✓tt-�� . TOTAL FEE $ CCC%%% OWNER HARRISON, Mrs. B. DATE 5-11-62 JOB ADDRESS 2737 San Carlos Lane BUILDING PERMIT NO. 17027 GENERAL CONTRACTOR Anthony Pools VALUE $ 2200.00 _ AP No. LOT 45 TRACT 4285 FIRE ZONE DESCRIPTION OF WORK Pvt. Sw. Pool INSPECTIONS Signature DATE GROUP TYPE ZONE R-1 Sail AIJ-Cr.- - 6.114 4. /Yaa PERMITS ISSUED Gas 0,, Ar —/99� SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. ❑ Air Cond. D 1RRough Heating1.7 l x , � �_ _i/(( ough Plumbing J / t7' /CAS- GY 37 7 Miscellaneous Prop.Swr.Line ❑ House Con. 0 St.Swr. 0 Sprinkling System Construction Pole . Underground ❑ -P.,...., 0' ///j/J'S _ Rough Wiring _'f �s� �i 4 $ eeeJ (e- Gv / (u 5 X irencf s JjL, Forms L eel em . AL re—/— Floor System Bond Beam$.. Steel Reinforce P�- F. �,9�, .-- _q- Sheathing �� vi Frame and Flashing _ CY_ Lathing — In 0 Out 0 n�g T! G Plaster, brown coat !)X/ Ina -. Refrig. 0 Air Cond. 0 Final 9 f ( 1' Heating, Final i Plumbing Fixtures, Final Final Gas Test /.6' �../i 0///7.,i 7.../ Electric Electric Fixtures, Final u' Building, Final J!(/ 9-.. .-. \ \ OCCUPANCY FORM 13114.5M — 7-61 17027 ('-Cl i f-1:1_52� . Lot )45, Tract [FEEPSI iv ED 19 . COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.p�. ?i.. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill•In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING -BUILDING 2737 S ADDRESSan Carlos Lane . COSTA MESA. CALIFORNIA For Office Use Only OWNER Mesa del Mar Development-Co. I RECEIPT NO. I 4 IERMIT NO. < T�^SUED MAIL p g.g RECEIVED BY I DA$'BEEEI [ODATE ISSUED ADDRESS 3800 E. Coast 1 hway ' Y/�� Ir?/ /9/ X cr-y Corona del Mar, Calif. NOL:OR 314220 BDDREIN • ARC'—ear TEL. OR NEER Macco Corporation NO.OR 314220 COSTA MESA. CALIFORNIA ADDRESS 3800 E. Coast Highway • FIRE ✓ PI?ZONE TYPE GROUFJ Macco Corporation APPROVED BY DATE . ADDRESS 3800 E. Coast Highway ZONING t ZON NO.OF UUSE OF NEW �' O clrY Corona del Mar, Calif• • pLANB BUILDING 1 r A STATE 98808-SB-1 TEL.OR 314220 LEGAL. -I-0 ;�� r./— } V. r— LIC.NO. NO. . �� �,O •T DESCRIPTION I ( ` / '.i VELOT NO. OF BLDGB of LOT - 6696 S F NOW ON LOT none A.P.NO. USE OF None YARDS EVES EXISTING BLDG. APPROVED - ALLOWED ETBALINE FROM (CENTER LINE BT. S CENTERCK oP STREET 41sT REAR YARD 261 FRONT 4111 FT. IN. SIDE YARD I LEFT 51311 I RIGHT 51 R.SIDE J FT. �I IN. DESCRIPTION OF WORK L.SIDE 7�/ FT. N. NEI I XX II ALTERATION I II ADDITION I REAR C_ ID FT. G IN. REPAIR II MOVING I II DEMOLISH I APPROVEDA/�BY /B DATE 11/4BB DING6119U x 531 ROOMS 7 STORIES 1 7f `�Q EXTERIOR WALL, ROOF /� ' COVERING . Stucco COVERING wd. shingles Living area 1685 S F USE OF BUILDING AND WORK TO BE PERFORMED Garage area 14i0 S F Single family residence ' Covered porch.etc 68 S F w/attached garage . 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 COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL COY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. VALUATION `/ SIGNATURE 01% 4esa Dpl Mar Development Co. PERMIT FEE $ d N PERMITTEEp 1 B Dy $18,2L17.00 PLAN CHECK S / 9, it E AUTHORIZED TOTAL FEE $ 57.00 E = ' � 17027 F E RECEIVED ' MAY 1 11962 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant fo Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT LANE A*�y. BUILDING . 2737 SAN CARLOS LANE BUILDING ADDRESS . COSTA MESA. CALIFORNIA For Office Use Only MRS B HARRISON RECEIPT NO. PERMITr/ NO. OWNER /7 ,�� MAIL RECEIV D,SY DATE RECEI ED }FATE 1IS5 ED ADDRESS 2559.. SANTA ANA y�1 16 -/i-4 I ,_, -//-6.2- clrY COSTA MESA N . BUILDING ADDRESS 2737 SAN CARLOS LANE ARC'"TECT TEL COSTA MESA. CALIFORNIA OR INEER NO. ADDRESS ZINE ZONE JJTTTT{''''''����� TYPE I AATRO /�� CONTRACTOR ANTHONY POOLS APPRO C �tl111-� . BY DATE 7 (/- ADDRESS 5871. FIRESTONE BLVD. ZONING CITY SOUTH GATE EONE�` I NO.OF USE OF NEW�t/,/)� PLANS 7l BUILDING Y v `'(— STATE 190179 TEL. LEGAL V LIC.NO. NO. DESCRIPTION LOT 45 TRACT 4285 SIZE OF LOT (I d q I NO. OF BLDGS. /7�'� /� ��/) NOW ON LOT A.P.NO. OA1 1 =/ L/. USE OF YARDS 1 EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.) � Q CENTER OF STREET REAR YARD FRONT � FT.r�,Q i IN. SIDE YARD I LEFT I RIGHT R.SIDE 02 3 FT. - IN. DESCRIPTION OF WORK /Z FT. IN. L.SIDE NE' I VII ALTERATION I ' II ADDITION I REAR ((.. FT. 11-62,--- BUILDING PROV fe, REPAIR A I MOVING I I DEMOLISH I BYI ��� DATE •� •• -6z- BUILDING NO. OF {t\ SIZE ROOMS STORIES 3(./ . EXTERIOR WALL ROOF . COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED SWIM POOL PRIVATE • I HEREBY ACKNOWLEDGE /HAT I HAVE READ THIS APPU CATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT T B VE IS CORRECT AND AGREE TO COM- PURPOSE Op ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CI 0 DUNCES AND STATE REGULATING BUILDING CON U N. VALUATION n SIGNATURE OF PERMIT FEE S�� P^/ PERMITTEE I U' n ./��J�� /pJ/ �� J/ $ PLAN CHECK $ AUTHORIZED AGENT ,C3r .LLJelie-L�.(�Z/ 2200.00 TOTAL FEE tLrE� et 0 II.