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HomeMy WebLinkAbout1579 SAN BERNARDINO PL - Building Permits ADORE4 BMLOg1G: 1579 SAN BERNARDINO PL Ufa: CITY OF COSTA MESA — BUILDING PERMIT 7"'' DWNERINANEIFIOIO# : SPELKE JON PERM NO: B 081091 '''' 1579 SAN BERNARDINO PL 1 COSTA MESA,CA 92627 PERMIT NO: B 081091 PLAN CHECK NO: N GOVT: N SUPP: N ' 548-1714 . A APPL.MMIDID ADDRESS; CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCNRECT OR ENGINEER: UG NO,: JOB DESCRIPTION : T/OFF SHEATH & REROOF W/BUILT—UP SQ FT: 2, 600 • ARCH.OR ENG.'S ADDRESS: LIME: CLAIM VALUE: 2, 600 . 00 CALC—VALUE: 2, 600 . 00 GROUP OCC: R-3 /U-1 +TRACTDWSNA"E:LEE ROOFING OF COSTA MESA ( 714 ) 642-7223 CONTRACTOR'SMMLING 1653 SUPERIOR COMMENTS : REROOF RESIDENCE W/BUILT—UP, SMOKE DETCTORS REQ PER 94UBC inE p ADDRESS:COSTA MESA CA UC.NO,: 349686 *****xi61E+E*�t***at1E1E1E�t*1E****�E*** Eat*SESE*16�E*** -*iter -�E�E16****+t*** -**,lf�Si,tl t 0.J��!'� 92627 BLIT Z ON ING R E Q U I R E M E N T S .�yf V. ;•„y LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter S SETB ACK S I R fN��lid, (commencing with Section 7000)of Dhsbn 3 of the Business and Professions Code,and my license is in full force and effect. [: •' 1„�IJ—AJ.f.0—— CrTYLIC.No.:028751 UC.CLASS:C-39 LIC.NO.: 349686�/-� �lEXP : 03 /97 MAIN BUILDING • ACCESSORY BUI)LDF Dae: / — `3` 7¶7 Contractor: rr /CA of i„ , FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN S LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law far the following reason(Section 7031.5 Business and Professions Cade:Any city or county which requires a permit to contract alter,improve, PARKING REQ: P RO V: PARCEL: 42532131 Z N E: REF NO: demolish,or repair any structure,prior to itsthe applicant for such permit to file a signed statement that he or she sauance.also requires . demolish, is licensed pursuant to the provisions of the Contractors License Law)Chapter 9(commencing with Section 7000)of Galion 3 of the PLANNING NotES> Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > A 7031.5 by any applicant for a perms suMects the applicant to a civil penalty of nal more than the hundred dollars 155001). ********************************************************************3* ********* ❑ L as owner o theprolarty famyempbyeesern wages as nnf sole compensation.wilt do the work,and thesWcture is not intended DEVELOPMENT V E L O P M E N T S E R V I C E S R E U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:Tiro Contractors license Law does not apply loan owner of property Q who builds or improves thereon,and who does such work himself or herself or through ha or her own employees,provided that such 0-. improvements are not intended or offered for sale.ff.however.the building or improvement s sold within one year of completion the ZONING APPROVED BY DATE: '! wnerbuider will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.as owner of the property,am exclusively wMredip with licensed contractors to construct the project(Section 7044.Business end /% Professions Code:The Contractors license Law does not apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY : DATE : contracts for such projects with a contractor(s)licensed Pursuant to the Contractors License Law). 's ❑ lamexempt under Section: B.SPC.,forthis reason: APPLICATION ISSUED BY: � DATE: I. 0 *1 Dale: Dale: Gwner: ********************************************** **************** **** * **** LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533.end a 534,permit thaluio ormodificationbvibirpomt occupant DtodtyMsnanol gementrcle edlocomply wiltseNmaeoodeses&e exequinmm these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE ', SMIP/RES GRADING 2 permit lit that I or any future building o paAmus tiL it nol(cemeot District)na toekeMiyl mrMadist to code and t exempt from is for provisions. PERMIT 74 . 75 h . ) . 50 Date: Applicant _ f' •' SMIP/NON —RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: PLAN i"• I have and will maintain acenificate of consent loseffinsure for workers'compensation,as provided for by Section 3700 of the Later BUILT FEE 1,❑ Code,for theperormaaeortheworkforwhichthispermhaissued. BUILDING DIV > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ I have and will maintain workers'comby pensation insurance,as requiredSection 3700 of the Labor Code,for the performance of the TOTALS > 7 5 , 2 5 0 , 0 0 0 , 0 0 7 5 , 2 5 7 5 , 2 5 00 work for which this permit is issued.My workers'compensation insurance carrier and policy number we: ' Carder: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 75 . 25 OVER/SHORT: 00 Policy Number: 13alfialf-34:6 06/30/97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed k thepennk is for one hundred dollars(tlOOjor less) 74 . 75 ,v' . 50 .1 •t, ❑ I certify that in the performance of the work for which this penile is issued.I shell not employ any person in any manner so u to became subject to the workers'compensation sue d CSiomi,and agree drat 1 should become aubled to the workers' ***************************************************************************I(*** compensation provisions of Section 3700 of the Labor Code.I shall forthwith with those l / Oa s: /_`7 0! 7 / °Y �"X�C IND I VIDUAL F E E B R E A K D O' W N Warning:Failure to secure workers'compensation coverage la unlawful,and shall subject an employer to criminal penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($104000),In addition to the cost of compensation,damages as provided fir in I Section 37DspineLabor Coa,IntaaaAand a omaya eau. SFR 2600 ••.•-, REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 , 2 , 600, 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a constmction lending agency for the END OF FEES • • performance of the stork for which this perms is issued(Section 3097.Civ.C). - LENDER'S NAME AI LENDER'S ADDRESS: I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances �` i, and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property ny for inspection purPoset. I .-t WILLIAM HARDEN / JPrint Name t / 11-89-1997/12:26 PN/$75,25 RCPT#:81-888883 ng j y Dale: /- 97'- 57 PERMIT:e81091 1 Signature dOwner/AgentApWcant/Contrmor • (5151d6.WP) White-Building&Safely:Green-Ale:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor ;rr ''et - -- -. CONSTRUCTION AND PLANNING - POOL &SPA Date Inspector ' - " _ Date Inspector i,:,_ APPROVALS Permit# APPROVALS Permit # • 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location, 2. Soil-Pipe-Undrgrnd.. . 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd.- *54:. Ferenc, • - ' 7 - . 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. - f -60. Backwash-Lines,'P'Trap, 0 Undrgrnd. 10. Structural Floor System 61,, APPROVAL TO DECK - 11. Property Sewer Line & House Connection ,62. Backwash & Receptor-Fina'• 12. Sewer Cap - 63. Heater & Vent-Final . ' _ . 13. Roof Drains - 64. Plumbing System -Final I. 14. Rough Plumbing - 65. Electrical-Final . 15. Rough Electrical-Conduit. - ° : 66. Solar-System-Final r - 16. Rough Electric Wiring 67. Fencing & Access Approval ' - - 17. Rough Wiring Sign • •68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning - - ' - 'FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts,Ventilating" , 71. Product Piping 0 Gas ❑011 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing &Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: --/ 34. Final Heating& Air Conditioning g7 D t 4 7iy,,o ' 35. Final Gas Pipe-Test I-10- L. f-` t� /6� 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 l (Ci'l ?„--- �t / /64_,€.8 ` �O ��f 44, Landscape Irrigation System . _/ - !/"C. ,- ,. , a- - 45. Sound Attenuation �� 6L n .J 46. Handicap Regulations -• r 47. FINAL STRUCTURE& BUILDING 1.2o -77 Gw 48. FINAL PLANNING ` 49. Electric Release to Edison •.� t? 50. Gas Release to Southern California Gas Co - - _. 51. CERTIFICATE OF OCCUPANCY No Date els /7y ADDRESS OF WILMS 1579 SAN BERNARDINO PL uNT: • CITY OF COSTA MESA - BUILDING PERMIT OvnnNAMEIPIMOYIN: SPELKE, JON PERM NO: P 087405 ADDRES4 1579 SAN BERNARDINO PL • COSTA MESA,CA 92627 PERMIT NO: P 087405 PLAN CHECK NO: N GOVT: N SUPP: N APPL.MAILING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH ARCNIT5CTORENO"EB: lie.NO.: JOB DESCRIPTION : WATER HEATER CHANGE-OUT SQ FT: ARCH.OR ENG.'S ADORESS: wit CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / '''''''GEORGE BRAZIL ( 714 ) 541-9753 . ca"mACTDas"Alu"D 3022 N. HESPERIAN WY COMMENTS : NO OTHER WORK AUTHORIZED BY THIS PERMIT ADDRESS: SANTA ANA CA uc."o_ 679898 crit**********************************Menet)taer*:t*it*****:E**:(-**:t:t:t*:t:E*at*:t********It*3ti: 92706 wit 101 Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Slim under penally of perjury that I am licensed under. • ';,..._ .. ..er S SETBACKS • (commencing with Section 7000)of°ivoion 3 of the Business and Professions Code,and my license is in fu +.and effect. CITY UC.No.:O.0568 um cuss: C-20 �N0'` _ • 89 : ,� ' • : : / MAIN BUILDING ACCESSORY BUILDING D•e: 7-13 q Contractor i_�. _ Illeka..._--- , FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN .W ER :•ILDE' DECLARA ON:1 hereby affirm under penally of•.jury I I:,, ,emp • the Com:.on License Law for the ••lowm• :aeon(Section 7031.5 Business and Professions Code:Any c ono my itch requ es a permit to construct,alter,improve, ai or repany structure,prior to its'sauene,aeo requires th•••Scant for wall permit to •: •signed Moment that hes she PARKING REQ PROV: PARCEL: 42532131 ZNE: REF NO: le licensed penuanl to the provisions d the Contractors License Law(Ch:. : 9(commencing with Sedan 7000)of Division 3 d the PLANNING NOTES> Business and Professions Code]or that he or she is exempt therefrom end the basis for the alleged exempan.Any violation of Section > 7031.5 Went applicant for aperste subjects the applicant toacivil penalty dot nmore than love hundred dribs13500)). ******************************************************************************* ElI.as owner of the property or my employees with wages as their sole compensation,will do the work,and the structure is not intended saleC. DEVELOPMENT SERVICES ', REQUIREMENTS S who bids or inpoves thereon.end who does such work beset or hesel or through his or her own employees,provided that such • �. improvements are not intended ora offered in She II,however,the building or efo the purpose is sold fwithin aone year of completion.the owner-0uiMer w;3 have the Wdendpwirg ha«she did rid add aimproe for the pempeedeale). ZONING APPROVED BY - DATE: ❑ I,as owner of the property,am exclusively emending with licensed contractors to castrud the moped(Section 7000,Business and ,( • Professions Code:The Contractors License Law does not apply to an owner d prorted),who builds re improves thereon and who BUILDING APPROVED BY : DATE: a ,•y contracts for such projects wt a contrador(s)licensed pursuant to the Contractors License Law). Ellemexempa erseion 1 B.AP.c.. aNereason: APPLICATION ISSUED BY: �Er�/ DATE: 1O �/ Dee: owner: ****************************************** * * **************** I do hereby ' Mal I em e d and understand the requirements of California Health and Safety Code Sections 25505,255.33,and LEGALIZATION:N F E E SUMMAR Y STRUCTURAL SE MEN T:N 25534.and Ihet or any Mu a Willing oc ipanl will f wit not(circle one)need to comply with said date codes and the requirements for a pennkforconsmctiun or modification from theAiOuality Management District.Residential conelrudanappiutias are exempt from Nese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 11 . 00 Dee: Applicant: 25% SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one of the following declarations: PLAN 1:1Ihave and MImaintain acertificate dmnaentmaal:inwnworkers' ,asby forcommpensationproidedfor Section 3700ofthtabor ISSUE FEE 22 . 00 Code.for theperformanceSNewrkfawNwthispermiisissued. BUILDING DIV-> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE cifI have end wilmSntan workers'compensation insurance,as squired by Section 3700 dune Labor Code,for the performance d the TOTALS----> 11 . 00 22 . 00 0 . 00 33 .00 33 . 00 . 00 work for which the permit is issued.My workers' 'umcarrier compensationrance and policy number we: Carrier: ATF C'(1MP Fi7NT) EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 33 . 00 OVER/SHORT: .00 Ploy Number. 467401-98 01 /01 /99 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK ved/on need nor be completed I the permit is for one hundred dollars h. . or less.) 33 . 00 l'.l{I certify that m the Worme's,d the work for which N pelma 1 shell nor manner so ar,'.. t ton ea., „00 of Iha ofC� ith co pty :° ************************************************************************* ompensd• prmnaIons. Sect'• 3]00 of the Ldw C with compA' **** a 41 t /�� I N D I V I D U A L F E E BREAKDOWN ateAVpcanl/—- . —' Warning:Fal to secure eskers'compensation coverage and Mane tan anaat• . to ' penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up .one nand-•thousand dollars(3104000A addllon to the••st of npensatlon. -i mages as provided for In s«gon3708o1NaLabor Code,lmac.n,end aromeyaf.. ' PLU 1 WATER HEATER AND/OR VENT 11 .00 11: . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of hat there is a canSsdlending ding agency forthe re END OF FEES perfoperformanced the workork forr which this permit is issued(Section 3097.Ce.,C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read M. ...icatan and Sete that the above information is. ,: .. . agree to campy with all city and county ordinances - and state laws Satin. •.uil.- .construction and hereby authorize rep dives of NA city to enter upon the above-mentioned propend for inspection pun•:• 9 S 03-28-1998/03:2A P91t33.0H RCPT8:01-w21213 /_ I 3 7- g PERMIT:087tg05 ��I S �- Y' Date: ) / 7gneN'�'�•� -•.ken ':7. • (5151-45.WP) White-Buildig&Soley:Green-Ale;Cavy-Appicant;Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING ` • - POOL & SPA - • APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location'• . ' , . , 2. Soil Pipe-Undrgrnd. -• - 53. Steel Reinforcement- - 3.. Electrical Conduit Utility-Undrgrnd. - 54. Forms - . 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding _ ' .. 5. Steel Reinforcement _ ' 56: Rough Plumbing & Pressure Test 6. Electrical UFER"GFnd. 57. APPROVAL TO COVER-GUNITE '- • i 7._Footings I - 58. Electrical Cond"u`_it-Undrgrnd. 87.Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9'Water Pipe-Undrgrnd. • ' f 60. Backwash Lines;:?.-Trap, 0 Updrgrnd. • 10. Structural Floor System 61. APPROVAL TO•DECK r• 1 P.'Property Sewer Line & House-Connection62. Backwash & Receptor-Final 1 12. Sewer CAP '� • 63. Heater & Vent-Final 13. Roof Drains • 'I 64. Plumbing System - Final " - 14. Rough Plumbing ,e 65. Electrical-Final 15. Rough Electrical-Conduit . 66. Solar System-Final 16. Rough Electric Wiring _ - 1 67. Fencing & Access Approval , • - , 17. Rough Wiring Sign ( 68. APPROVED FOR PLASTERING •• 18. Rough Electrical-T Bar Ceiling r ` 69. POOL/SPA SYSTEMS FINAL. 19. Rough Heating & Air, Conditioning - -, ,r,• • a FIRE DEPT.-REQUIREMENT' .1 „J , ' 20. Rough Factory:Fireplace • _ 1 •^ -'APPROVALS- •^ Permit # 21. Ducts;in-Structure i -,. . � • • 70. [Underground Hydro - 22. Ducti; Ventilating . - - - •- - ;: 71. Product Piping OGas 0 Oil 23. Gas Pipe-_Tough&.Test - - •- 72. Underground Flush 24. Roof Framing . - '. : 71' Undergrnd.StoFage Tank.O Gas 0 Oil 25. Roof'Sheathing r -,. 74. Overhead Hydro` 26. T-Bar Ceiling (Structural) & Mono-coat C. m 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.• I. ' 79. FINAL INSPECTION .� 32. Electrical Power Meter-Final 2 80. FOOD CERTIFICATE ISSUED-, . 33. Final Electric 1 • Notes: lc 34. Final Heating,& Air Conditioning- ^-. _ • % NO A $S /f 35. Final Gas-Pipe-Test' . , ' _ ' 36. Hood or Canopy - - - . . 37. Final Factory Fireplacer - - • ; ; � . , 38. Final Plumbing - IZO/•8 /'/Ii ^ - _ 39. Water Service-Final ' - - ,ti. - ' r q 40. Gas Service-Final . ' : ',- _ 41. Solar Domestic-Final - • " - -_ 42. Backflow Preventer , r; - _. , • 43. Backflow Irrigation - . r 44. Landscape Irrigation System - r 45. Sound Attenuation • 46. Handicap Regulations it .. - , >, 47. FINAL STRUCTURE & BUILDING H. J: 48. FINAL PLANNING., -------r•-•; r-, - - • 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co ; • 51. CERTIFICATE OF OCCUPANCY - -Is No. Date _ - - APPIICd ntto fill in all spaces except those-within heavy border lines and sign all appropriate declarations. . . . CITY OF COSTA MESA N$ UCTIO PERMIT NO. TRACT NO. LOT NO. UNIT NO.; A • Project Address )15-#75.6.44-1? w//)•' - I �nmay �� • q , .N' . TYPE OF CONSTRUCTION NEW ❑ ADD. H ALTERATION H REPAIR pplicant'sMail/'n Address /$"hr�. I /N fl/ 1 J'/,..,-0 ❑ CONVERSION ❑ DEMOLISH_0 OTHER q,p-#- - • s � Zone • _ Owner's Nam //�C`i tlf�/ Phones /�p� • DES "TION OF)/OR WORK/USE OF BLDG. — - • f{ Address �7r+ �/ ax �/��. �� ,�, . / +r - S Main Building: kecAssor eBulldin9: . Arch/Eng. Z90D,C''o�moti License No.rJXZZt9 TYPE OF PERMIT A G•ADING 11 FO DATION . STRUCTURAL T Front „y \ ZO Address 440 .E/ eainhro Q • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear - r'✓J yJ�' ` ±l • N Contractor's Name UAA/C.Q� Phone�/7/jari/ • OTHER - - - C Right /f _gyp f:4. J/ • G ���nn�yp �/ � ///'''�� G1 PROJECT DESCRIPTION SQ. FT. ¢fa OCCUPANCY . K R Address(mailing)•cr'• /j /{e/•(� /�� jf(j !CONSTRUCTION TYPE VALUATION$ 12 Oj1/a eO Left 1 r ! _' City License No. Ar75- v A S 'V! R ZONE GRADING CU.YDS. ACRES - Ping. Ref.# Parking Req./Provided LICENSED CONTRACTOR DECLARATION. , - - Q I hereby affirm that.' am licensed under provisions of Charter 9 (commencing Remarks: i• Gs _ ['LJ ' • _ Planning Notes:* i'' - M with section 7000) of Division 3 of the Business and Professions Code,and ( 0(/ / e' - - my license is in full f rce and effect. � T License Class A ii se N•. -t'_: .;Y - - S Dat-. - -- Signature .fafle- „ - PLUMBING ' - FEES ; • - - , WORKERS'COMPENSATION DECLARATION • I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink •Showers , -• - - - , ELECTRICAL - FEES . of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer • Service Sink ' 3800, Lab. CJ - Automatic Washer• ' 'Transformer ❑.15-50 KW PolicyNo. /+� I - - •• � r CompanyfLp�np✓� Backflow Irrigation Sewer Cap Construction Pole Sub. - D 50+ KW Certified copy is hereby furnished. ((. /) 1 . _ certified top I iled with the city BW 'ng Di to Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps , - Date-6.-27- / Applicant L _ EXEMPTION FROM WORKERS'COM PE NSA ON DECLARATION Clarifiers Solar Collectors. Dishwasher. ,' - Meter Dover 100 amps - • (Thissection need of be completed if the permit is f•r one hundred ($100) or - - less). Dishwasher Solar Piping - I Dryers (]Gas DElectric; Sub Panel • I certify that in the •erformance of the work fo filch this permit is issued, I . - . . - shall not employ an •erson in any manner -• as to become subject-to the Drinking Fountains Solar Tank . Fan Motors ❑0-1 HP ❑1%-8i Workers' Compensation .ws of California. . _ • Date ignature , Floor Drains • Swimming Pool w/Spa F,A.U. . " Inc.Solar ❑g-15 HP LI 1'6-15+ NOTICE:If,after making th deblara "•n, you should become subject tel the - - •— -. -- -- Workers' Compensation provi •ns • the Labor Code, you must forthwith Floor Sinks comply with such provisions • this permit shall be deemed revoked. Urinal Fixtures • Microwave CONSTRUCTION LENDING •G CV -Gas Service Outlets Water Closet • Device Boxes ' I hereby affirm that there is . onstructi• ending agency for,the performance - Pole Light - of the work •for which his permit is ' sued; (Section 3097 Civ. C.) - - Interceptors • Water Heater •' Outlets Lender's Name. _ - Range • . • Lender's Address • - i - Kitchen Sink -' - -Water Service' -- . ' Switches - ' - Sign - OWNER BUILDER DECLARATION I hereby affirm that lam exempt from the Contrac ores License Law for the Lavatories , , Auto-Wash GarbageDisposal ' following reason (Section Z031.5 Business and Professional Code: Any city or Standing Sections ' county which requiresla permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays 1 Generator ❑0-5 KW ❑5-15 KW ' any structure, prior to,its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of ROOF Drains - - the Contractor's License Law(Chapter 9(commencing with Sectioo7000) of - --- _ ---• Division`3 of the Business and Professions Code) or that he/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 enalty of,not more than five hundred dollars($500). , i U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 • ' compensation, will do.the work, and the structure is not intended or offered - • Reinspection Fee ! $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 or Type I ❑ • l sale. If, however, the building or improvement is sold within one year of corn- , _ Canopy Type II ❑ - Zoning Approved By Date pletion, 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). n..• ❑ I, as owner•of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System •Application Issued By sLf�{/ Date 47 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 • ❑0.100,000 BTU 0100,000 BTU - �� SUM7A8`;'OF'FEES builds or improves thereon, and who contracts for such projects with a con-. - - - tractor(s) license pursuant to the Contractor's License Law). I am aware that - LDIN PERM! $ SMIP • $ • of Exhaust System ❑ Multiple❑ System Repair/Alteration proof their Worker's"Compensation•insurance should be provided to me. - - • - - ,LAN CHECK $ PERMIT I ❑ I am_ exempt under Section B. & P.C.for this reason . Firepl/Fact.Bit. ICBG 4 - Fire Dampers PLUMBING • $ ISSUANCE $ Date • ' . Owner - - Heating System& Ducting Registers - PLANICHECK 25% $- ENERGY P.C. $ I hereby certify that,' haver-.. is application and state that the above I 00-100,000 BTU 0100,000 BT - - ',$ GRADINGI - .$ information is correct..)-agree o co ply with all city and county ordinances - - . - _' - ELECTRICAL _ ' • and state is •ating,to bu' ding .onstruction,and-hereby authorize repre-- . PLAN CHECK 50% S. • MICROFILM'. $ - - sentatives 0 thi. city to nter pon the above-mentioned property for - - - - inspectio 'purp..es. _ - MECHANICAL •$ TOTAL FEE $ i� Signatu a•� s. ADi _. - - Date...3'1-2 7� Reinspection Fee $15' Issoe'Fee ' - $ 3 PLAN CHECK 25% $ • Drivers'-License or SS.16 . -• - - _ _ , — _ - - CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor 1 CONSTRUCTION AND PLANNING POOL&SPA APPROVALS • Permit# Date Inspector• APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole , 52. Pool &,Equipment Location 2. Soil Pipe-Undrgrnd. - . 53. Steel Reinforcement . 3• Electrical Conduit Utility-Undrgrnd. 54. Forms ' . 4..Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. ' 57'. APPROVAL TO COVER-GUNITE r_ , ., i- , 7. Footings I - 58. Electrical Conduit-Undrgrnd. i, r , 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60.. Backwash Lines,P-Trap, 0 Undrgrnd. ;, !1r. • 10- Structural Floor System - 61. APPROVAL TO DECK - ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - - • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final , 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final ' 16. Rough Electric Wiring • , - •• 67. Fencing & Access Approval • 17: Rough Wiring Sign - -68. APPROVED FOR PLASTERING 181 Rough Electrical-T Bar Ceiling ' • 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning I FIRE DEPT. REQUIREMENT ; - • 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • ' 71. Product Piping 0 Gas 0 Oil - 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil ' 25. Roof Sheathing . - 74. Overhead Hydro • J 28. T-Bar Ceiling (Structurall•&•Monocoat . 75. Dry Chemical - 27. Frame and Flashing , • 76. Dry Standpipe .- 28. Lathing & Siding 77. ' FIXED SYSTEM FINAL . 29. Insulation 78. FIRE PREV. FINAL , ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT '' 31. Plaster Brown Coat • • 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ic- 33. Final Electric ' Notes: • . 34. Final Heating & Air Conditioning 'r^ 35. Final Gas Pipe-Test 1- 36. Hood or Canopy / / 37. Final Factory Fireplace ' - , 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final - r - 41. Solar Domestic-Final - • ' , 42. Backflow Preventer - - 43. Backflow Irrigation. li • -' 44. Landscape Irrigation System i . , r - ' ,45. Sound Attenuation - • - . 46. Handicap Regulations - .' :47. FINAL STRUCTURE & BUILDING 0 i tad_ + , �� , ' •48. Special Requirements Completed • - - •� . 49. Electric Release to Edison 50: Gas Release to Southern California Gas Co - - // • 51. CERTIFICATE OF OCCUPANCY - • / No. - Date i CONSTRUCTION AND PLANNING . . _ POOL& SPA - J1 APPROVALS Permit,#' - . .r Date Inspector APPROVALS Permit# Date Inspecto/ 1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. '' - • 53. Steel Reinforcement 2.(24f87 0-0-3. Electrical Conduit Utility-Undrgrnd. 54. Forms' ' . - . . >M - 074 4. Electrical Conduit-Undrgrnd. • - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ,j, LZ gl °R-. 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE, y //81 et 7. Footings ' 58. Electrical Conduit:Undrgrnd. •! ag 0,- 8. Foundation 59. Gas Pipe, Oktbdrgrnd.,Test 471 SQ- 1 �9. Water Pipe-Undrgrnd. • _ -- _ . - - ,--60. Backwash Lines, P-Trap, O Undrgrnd.l , Qa10. Structural Floor System 61. APPROVAL TO DECKQr 1.1. 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 - I 15. Rough Electrical-Conduit , . . 66. Solar System-Final ; ' 16. Rough Electric Wiring . - ' . - 67. Fencing Access Approval • 17. Rough Wiririg Sign '68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling '-' - 69. POOL/SPA SYSTEMS...FINAL iquip-1 DA- 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace - APPROVALS Permit#_ • ' - 21. Ducts, in Structure, 70. Underground Hydro : 22. Ducts, Ventilating 71. Product Piping ❑Gas it , 23. Gas Pipe-Rough &.Test . 72. Underground Flush ' 24. Roof Framing . 73. Undergrnd.Storage Tank O Gas O Oil 25. Roof Sheathing 74. Overhead Hydro - ' i - l. / 26. T-Bar Ceiling (Structural,& MonOcoat 75. Dry Chemical: - , 27. Frame and Flashing -.76. Dry Standpipe I. - 28. Lathing & Siding , : 77. FIXED SYSTEM FINAL• - ' 29. Insulation . 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - • 31. Plaster Brown Coat . I 79. FINAL INSPECTION • , ' - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final-Electric Notes: �.. . 34. Final Heating & Air Conditioning / r f iP4 , ', id{ -_ _ ►J_ ► / 35. Final Gas Pipe-Test /S '(�� 36. Hood or Canopy f 37. Final Factory Fireplace - ' . 38. Final Plumbing '' • I ' 39. Water Service-Final - - • 40. Gas Service-Final . • . "41. Solar Domestic-Final - • , - • 42. Backflow Preventer - i , fell . ,:43. Backflow Irrigation - 44. Landscape Irrigation System . ' A. ' 45. Sound Attenuation ' ' i I , 46. Handicap Regulations I 47. FINAL STRUCTURE & BUILDING - - '7, • I ',i1 ` I 48...Special Requirements Completed ' . . ' - y-, t 49. Electric Release to Edison r50.-Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY - - • No. Date - - i I _� ��� _ t r Applicant to fill in all spaces except those within heavy?ber^ r lines and sign all appropriate declarations. - TRACT NO. - LOT NO. UNIT NO. CITY CF COSTA M[�A CON1S•TfiUCTION PE,�MIT 25"F�°�-2 t D /� I 1b Projett A61resi�,_7'7 79� .4-,t/ 7iP2il/�lf.;(/n Pl ia, r lJ -- _• " •• '2616 2/•I 9/87 ; : 176.72 •7L ��jjU REPAIR CZ Ap"plicant'y'Mailinsg Address N'i47l7Qi - TYPE'OF CONSTRUCTION ❑ NEW ADD U ALTERATION ,u 'v ' �� �/� w/ / ❑ CONVERSION ❑ DEMOLISH El OTHER ` �ry f ZoneJ�P� Owner's Name' //N `l; kte .!'7-A/eePhonfree,elerl T • A.P.#. V 7r�� �� , '� 1 I',rt-r`z�Vnt'F.(;-'/'/,I- �(� cJ :;DESCRIPTION OF WOR USE OF BLDG Address ty7.��I1) 'ti 9..Iy i1MWiGt C� font Sn4 -- r. S Main Building pessoryBuilding• Arch/Eng/rttli7 .Ge147)-7License No. •30 TVPE'OFPERMIT -inADING FOUNDATION ❑ STRUCTURAL L.� ,.EFront. . •Address Ttnbilgo/f{go ❑ TENANT ❑ ELECICAL ❑ PLUMBING ❑ MECHANICAL _ • B Rear i,: I' t N �1 nil n Contractor's Name/+ L% Phone? ECT HES C Rig„ N _ ��-s�� '�� PROJECT DESCRIPTION • SQ. FT. GI n • OCCUPANCY - - K ` G Address(mailing) /n I CONSTRUCTION TYPE VALUATION$ ��A/J/7O S Le I1 ,S R City License No. ZONE GRADI NG CU.YDS. ACRES E ' LICENSED CONTRACTOR DECLARATION ,• Ping. Ref.# , _ Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' . pee- ,..,e,4 QG - Q'7` y : Planning Notes: pry)I ✓ , .*2 M with section 7000) of Division 3 of the Business and Professions Code,and / �/ a („J moi•"" - T my license is In full torte a effect. X _ eat: rnQ J. — / 1.1 /) , ,y- 1 ' I�n - S License Class G d a No.._ S•4 (,..( Y(Yflr ] �'f au ^(j• fUv`^�•r ' . ^ Date 2-- Signaturel� -, I • PLUMBING • FEES' , •tea' ��/�,-�_, 4\ WORKERS' COMPENSATION DECLARATION •Bar Sink • Showers ELECTRICAL • FEES hereby affirm that have a certificate of consent to salt-insure or a certificate - • - of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer. Service Sink 3800, Lab. C.) A / Automatic Washer i ran5fprmer ❑ 15-50 K • 1 Policy No. IC142z 3/ Company rR�� Backflow Irrigation • 0 50+ KW g Sewer Cap , , Construction Pole Sub: A Certified copy is hereby furnished. - �' Certified cop I filed with the city it ng Diyi�io /_1 • Bathtubs - r Sewer Connection • Cooking Unit ' • Meter Dup. to 100 amps © Date Z'� q/S ApplicanY� A y �2a�./ T.*. EXEMPTION :OM WORKERS'Cd'feENSATION DELL• ;ATION • , ; Clarifiers - Solar Collectors- • Dishwasher•-, I . Meter Dover 100 amps (This section nee• ••t be completed if the permit is for o • undred ($100) or less). Dishwasher Solar Piping , Dryers [Las ❑Electric Sub Panel I certify that in the per • ••ante of the work for wh ' this permit is Issued, I - ' shall not employ any perso any manner so to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP 01%-8 • Workers' Compensation Laws of ornla. . _ - _ Date Signature Floor Drains /♦ SwimmingPool w/Spa /�NOTICE:If,after making-this declaratlo•, . should become subject to the ! p . �(hJ F.A.U. Inc.Solar 09-15 HP 016-15+ Workers' Compensation provisions o e Lai. Code, you must forthwith Floor Sinks ' Urinal Fixtures comply with such provisions or is permit II be deemed revoked. - Microwave• CONSTRUCTION LENDING • ENCY Gas Service Outlets Water Closet - I hereby affirm that there is . onstruction lending agency for the performance Device Boxes •• / Pole Light • of the work for,whi • this permit is issued (Section 3097 Civ. C.) ' - l Interceptors Water Heater Outlets / Range Lender's Name 9 • • ' Lender's Address ' Kitchen Sink - Water Service, Switches , - / Sign ' - . OWNER BUILDER DECLARATION - • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator ❑0.5 KW ❑5.15 KW Trash Compactor any structure, prior to Its issuance, also requires the applicant for such permit P - to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ; / n.,�„� rave, the Contractor's License Law (Chapter 9 (commencing with Section 7000) of ( f,'.r ,,, Dl vision 3 of the Business and Professions Code) or that he/she is exempt -therefrom and the basis for the alleged exemption. Any violation of Section I • 7031.5 by any applicant for a permit subjects the applicant to a civil ' penalty of not more than five hundred dollars ($500). LJ I, as owner of the property or my employees with wages.as their sole Reinspection Fee' I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not Intended or offered • - Reinspection Fee $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: ' .�'yI, r/ employees, provided that such Improvements are not intended or offered for - Boiler Hood or Type I 0 ZoningApproved By 1/�`--• �i9 • sale. If,-however, the building or Improvement is sold within one year-of corn- -- ---- -- Canopy Type II ❑ pP /.�J- Date II++--�� 1 pletlon, the owner will have the burden of proving he/she didcenot build or im- • Duct- Under Ground Building Approved By Date �F 7 Drove for the purpose of sale). LJ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By • Data 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 ❑0.100,000 BTU ❑100,000 BTU - t ARV OF FEES builds or improves thereon, and who contracts for such projects with a con- . ti /�' s>\ tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ ;Ol VV SMTP $ /Z.47 / Exhaust System 0 Multiple 0 System Repair/Alteration proof o their Worker's Compensation insurance should be provided this to me. PLAN CHECK $ -_(9�•��� PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ ' Date Owner - Heating System& Ducting Registers _ PLAN CHECK 25% $ -• , 7s ENERGY P.C. $ ' I hereby certify that I have .q this application and state that the above ❑0.100,000 BTU 0100,000 BTL - t• n^ 0-0 GRADING $ Information is correct. I agr• toI•Comply with all city and county ordinances ELECTRICAL • $ rO and state la dating to •uild' g construction, and hereby authorize repro- - PLAN CHECK 50% $ ”-.5.s-0 MICROFILM $ . sentatives o th s CI to o.0 •r up•n the above-mentioned property for • _ ,-, . ''y}'am� y��� Iignat r•• purls, es. . -/ Date2-1,� • MECHANICAL $ TOTAL FEE $ t' � Drivers' License or SS qp - ! Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ I�(0 • T'7 �. . a l CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor COSTA MESA BUILDING DEPARTMENT FEE RECEIVED . . . R 0. Box 317 I6725 I _<,2-5-g COSTA MESA CALIFORNIA •II II FOR APPLICANTTOTILn IN C.L. OF STREET-'-e. r, 9CIiO� tom l ' �BUILDING ADDRESS f �G ,,, tri et fl/71H /, ' -_ ___ __JiPfis LINE _ _ _ _ _ I Owner �t,n , /�. oe4etreio / 10 FT. FOR 60 FT. STREET 12 FT. 61N. F3Ft Mail Address is-n •- J `50 FT. STREET � f // City C--0, S)11 /77 t St, Ph. No./.-1o f/ p d J '�0 Contractor a• t'• ` l�2 y Ph. No. 4/,�,>' � _ Address l% 7 rhoe %Ivd• ( sJ•r 'tut, I .50 F11OF FRONT City Lic. No. 714> State Lic. No. /3 7 hC I1I- 50 FT, w o Size of Lot/ft"/1�X it N , i / a o2/— rc I /t' /I w Z N Y Setbacks: C/L Street / Rear /e. �� 1-1:1 /� w m / Side Yard - Right r" Left c t J� K I to ;'% r n a . Type of Fence L Cs.,rr, *Cr, r E 4 ° h//rig IL ALLEY CR PF OP. LINE o p b A ; c. ,, io ti H' A -1 . I hereby acknowledge that I have read this applidation and state J m _ 620, ` I that the above is correct and agree to comply with all City Ord- ti V. L'_, I' a �% inances and State Laws regulating building construction. \11i - �. � a w I ` I'--' C :a F' Signature �•� — 1i acs " ' ¢ 10 of Permittee �1�+ _ J 4 . i C',;:u :r m FT Agent ci,.. 0 :_f: 37 6 IN. as .L y R FOR OFFICE USE ONLY FT .‹. i m 40 I Z U D aa FT 1 LO Permit No. J o ; _ m 47ar f' Iv 60 FT ST. Received by Date Received Date Issued 150 t I` ten„ � .5 S S F x ST. 'V 1 1= -� I � __.iPROP. LINE _ 1 _ 1 VALUATION \\ —— —— Permit Fee $ °R ci I ^a-O I I I $ �6l,•5. — Plan Check $ C.L. OF STREET-...„„ I . TOTAL FEE $ g- 0"--0 MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES -- - --- ' MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS Gunite------LS ) Post-Tensioned Concrete ( ) 1 REPORT OF INSPECTION ON Masonry ( ) Fireproofing ( ) Concrete ( ) Reinforcing Steel ( ) " RECEIVED MAR 0 5 1987 MIN TO: Com* 1TY- a Address : OWNER: i2LI NFQi �� ` k I PROJECT: ctliriryyvr•-) et- 'SPI Report No. Address: ( 5 )Z( Sc,y Oren O4Jo /DL, Permit No.R - Dig /b Architect: P '1 U ,i..xQ.Ci Itt,h, Contractor: Adccnte el e S 1 Address : Address : Engineer: rbea -t jQo,„ne Subcontractor: n)(.._;\Ls Lvtr-ic (Gunite) Address: Masonry or Concrete) Inspector: (ylc x a Address: Po- 'bt) ISgqriin.ac e Mix Used: V.'�- I Slump, inches: —Nzr. " Admixture: ---- Designed Strength, PSI : a�cra(D • The following inspection was performed in accordance with the approved drawings: Cu.Yds. No. of DATES Placed Cyls. Remarks VIAL 3(1-3 3 S1-eel,, \3c:.cl 1.•-•-) ca at)) 4-e( L Cct.aout e-\ t.c..-- U,.,,), ,,kc ok- N-A cQo - r r-.,..d.: 1 C25L 251 - (Pest;usT� r,J J-sx \ , C(J)2-i- CLQ• JJ otic S-ieeLi Copies of Reports to: (Indicate which Bldg. Dept. & furnish address of any not listed) 2 e. , "�, Twininq Laboratories of sousem Ca(ifo ta, enc. • -2" o r.'OF lilt I a 1 3310 airport Way / Mailing Aooress P.O. Box 47 / Long Beacn,CA 90801 / (2131426-3355 / (213)636-2386 / 1714)828-6432 - TESTING BRANCH OFFICE. 1514-D North Susan Street / Santa Ana.CA 92703 / 17141 5544645 March 12, 1987 Examination: SC87-2269 COMPRESSION TESTS ON GUNITE CYLINDERS Max Sitter • P.O. Box 3454 Fullerton, California 92637 PROJECT SWIMMING POOL & SPA ADDRESS 1579 San Bardino Place, Costa Mesa ARCHITECT CONTRACTOR Advanced Pools Advanced Pools ENGINEER SUBCONTRACTOR Reagan & Kramer Douglas Gunite SAMPLE FROM Deep End SPECIFIED MAX 4.2-1 STRENGTH 2,000 psi DATE CAST 3-3-87 SLUMP SIZE 4-3/4" x 124^ • DATE TESTED 3-12-87 SPECIMEN NO. 1 COMPRESSION 9-Day TOTAL LOAD. LBS. 69,000 POUNDS PER SO. IN. 3,900 28-DAY AVERAGE. PSI COMPLIANCE 9-Day test complies with specified strength. MADE BY DELIVERED BY RECEIVED ON SPECIMENS - Woody Max 3-5-87 DISTRIBUTION: Max Sitter - 3 Geeta Mesa Bldg. Dept. /6LP('-Lit-- Rick Hyden OWNER BEDDOME. GEO. DATE 5-8-58 _ JOB ADDRESS 1579 San Bernardino WI _ BUILDING PERMIT NO. 6725 GENERAL7� CONTRACTOR H. C. Bailey (Mortarless?) VALUE $ 225;00 N d1-10 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Concrete Block Wall GROUP J TYPE ZONE Rli PLAN NO. 6725 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches- Forms Steel 4- Floor System Steel Reinforce Chimney Re-Rod a& Bond Beam Frame and Flashing Lathing, In Out Plaster, brown coat • Underground soil W/G Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. • Sprinkling System Heating Final Plumbing Fixtures, Final Final Gas Test Construction Pole Underground. Power Rough Wiring Fixtures, Final 'OCCUPANCY 6r£4 • 5--45 'fl Form 210-5M-1-57 6725 OWNER KIRCHNER, Douglas DATE 6-29-78 JOB ADDRESS 1579 San Bernardino Place BUILDING PERMIT NO. 46310 Family Rm. Add ENERAL CONTRACTOR Owner Builder DESCRIPTION of WORK NAP No. 117-221-10 LOT 10 TRACT 1267 FIRE ZONE VALUE S 11,500.00 NSPECTIONS Signature Date TYPE GROUP ZONE R7 $SOII. _ PE�MITS ISSUED GAS SUBCONTRACTOR GAS Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE ' UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES U FORMS E STEEL REINF. I i FLOOR SYSTEM BOND BEAM STEEL Ely):yGCE 7I a r., ` _a SHEATHING 4i/x.77 , if V 1, I\ ! \ II Y '3 U II FRAME AND FLASHING I 1 I I1 /.—.'t h \A II 7 i 4 KI LATHING — IN 7 OUT Al›-"�p '__./ // 11 H \_ i1 PLASTER. BROWN COAT STRUCTURAL, FINAL Flertric - I HEATING, VENT., REFRIG. AND A.C., FINAL ,� __ 2� ¢¢ I PLUMBING. FINAL AND GAS TEST UTA I C__ �d't till; 1.- --- ______ ELECTRIC, FINAL BUILDING, FINAL JOB ADDRESS 1579 San Bernardino BUILDING PERMIT NO. 49b55 GENERAL CONTRACTOR Owner/Builder DESCRIPTION of WORK Ccrvietion of #46310 AP No. 117-221-10 LOT 10 TRACT 1267 FIRE ZONE VALUE $ 99 INSPECTIONS Signature Date TYPE V GROUP I ZONE SOIL P MRS SS D SUBCONTRACTOR GAS Date i Number I Signature WATER Plumbing ROUGH PLUMBING (L. s...2.4-bo9/6•ba „ d 7.,CfWD TV PROP. SWR. LINE ll HOUSE CON. U SPRINKLING SYSTEM MISCELLANEOUS ' ROUGH HEATING AND AIR CONDITIONING . f- TEMPORARY SERVICE OR POLE a ` an—Ma UNDERGROUND Et, POWER M10 C.t. 3.275o C_c_ 3-21-9c tl' a, 1 '1111=10•11•111 ROUGH WIRING C. �f-3.V-�`e ��in rtf'id1Va �, � TRENCHES FORMS ' STEEL REINF. 3...g.,-13.0 g \% Y FLOO9.SY,6ZEM 1.--2/-S.0 . OND BEAM it STEEL REINFORCE n N _�i HEATHING t1. .3 7-D. 4r: I''� J SIl- •. /` LAME AND FLASHING E l2 1 ops +- ATHING - IN r1 OUT a LASTEL. BROWN COAT 1lP TRUCTURAL, FINAL J`/ Electric )/ ATING, VENT., REFRIG. AND A.C., FINAL ao i;71//-6t) /,� /J/'to LUMBING, FINAL AND GAS TEST I �/ 'ILECTRIC, FINAL \BUILDING. FINAL SPECIAL REQUIREMENTS 40310 9O.BL. 1k - :> 1 6%29_%78 --- • COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 752 APPLICATION FOR STRUCTURAL PERMIT - For Applicant to Fill in Completely — Use Ink Only A' /,� S J ��/R,o �L• RECEIVLDATE RECEIVED D met- BUILDING p _ BUILDING ,S � 1 Q ADDRESS 7 l� I'%— 7/,�/ PERMIT NO. OWNER te•61-4 ,3 L. - nn�t Irk A.P. NO. / / C MAIL BUILDING ; �` Q- l Cl' / ADDRESS S�I-rs� ADDRESS /5/!y 9 �J�^ ?n�/�(„/[ CIT Vain.- 7g NOL so71Op TRACT/2_61 '7 LOT BLOCK CONSTRUCTIONA / ��`` NEWADD ALTER REPAIR MOVING DFMOI ISH LENDER /Vert fC�vt./ Safi. p-,yr BRANCH {/ OWNER g i CCT/V - -O ADDRESSwrise ^ �+�t_// �/y(.C{XGf( VALUE ARCHITECT //�� TEL. �•• /�/y �$ OR ENGINEER/ft/A-4 ./3AJp"h' NO. 7✓ 65.38 /� 4:1g/A4../ � ZONE TYPE GROUP Xi FIRE ADDRESS ALUZC� (� Al>V APPROVED CONTRACTOR OW not/g'� BY �� DATE ADDRESS TEL. ZONE e, NO.OF USE OF N W • CITY NO. LA�Z BUILD F STATE CITY YARDS APPROVED YARDS APPROV D gLIC. NO. LIC. NO. MAIN BUILDI G ACC/SSORY BUILDING BO SIZE NO.OF BLOTS. FR(FROM Cit.S R I�-'+ "•C`Y 6• OF LOT NOW ON LOT FRONT l/.lT � FT. Q USE OF U.r EXISTING BLDG. • FL SIRET. FT. 4a H Separate permits are required for L.SIDI� i�-e 4..�(1 FT. electric,plumbing and heating work. 7 - In I/ W _REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED E., DISTANCE ET. BET.MAIN& QIZI / MAIN SLOGS. ACCESS. BLDGS. 7(J "rt �C' M_'N Ad 0A/ling CURP.V#,Ep7 5'-77 APDAPROVE//6.�1�_'/Q _g_V R0/ A �P (+CJ SATE lL9/76... 'U m Q I hereby acknowledge that I have read this application and state HOLD in n Q$ that the above information is correct and agree to comply with LL FOR SPECIAL REOUIR�p��N m M all laws regulating building construction, and I shall not employ T5 Z any person in violation of the workman's compensation laws of W the State of California. - 3 I hereby certify that I am properly licensed as a contractor under 9-9 SO. FT. _ w the Slate of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m 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 • ' e • ovisions o..fww e State of California Business VALUATION PERMIT FEE $ �/' v and Professio - Code, D vision pter 9.C fOoi00 2 �O PLAN CHECK •$ in Signature of / S // 5OO �O �Q Permittee i/ TAX $ s �j / LL / U Authorized Agent TOTAL PAID $ 0,Q/ O ` 'I OWNER BEDD0ii1E, GEORGE ' - DATE 4-3-61 JOB ADDRESS 1579 San Bernardino Pl. BUILDING PERMIT NO.14205 ' GENERAL CONTRACTOR Frank Bissell Dld r. VALUE $ 2,640.00 AP. No.117-221-10 LOT TRACT FIRE ZONE DESCRIPTION OF WORKAdd Bedrm.!23ath:Fc INSPECTIONS y_/2L, DATE I GROUP I TYPE V ZONE Rh Enl.Kit. Underground Soil/WS U.G. Water 447t.j"-c6"-0/ SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gas Rough Heating /� /� Rough Plumbing 41--ic s--s--c/ Sed-UnE.4-ac 4 9-!i -G/ ca9/,?fV Miscellaneous , Prop. Swr. Line House Con. St. Swr. Sprinkling System _ Heating, Final Plumbing Fixtures 1._u/ (de-Ci Final Gas Test 00®,4.. _ ' /J 11/1/71-; Construction Construction Pole Or , 0,11 Underground Power • 1/ (p d. Rough Wiring .. c.7,�. 1/N -4-6,2 `/�?G/4. , / CtEf3/�/ Trenches Forms Steel P7' 'Ng "11' Floor System Steel Reinforce Chimney Re-Rod Bond Beam _ Sheathing a—c-t ei^17-1 I Frame and Flashing 8-EE/£ c- f -. Lathing, In Out ../Sit. 5 ($ -d I Plaster, brown coat t t- S' .3/ l _ Plumbing Fixtures, Final J•. W -q-C7 Electric Fixtures, Final 11/ 41 6- , r Building, Final /at/ C /4'u/ I OCCUPANCY �t Form 210-5M-11-59 5-B P 14205 x.4205 FEE RECEIVED �� MAR 311961 COSTA,MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT �J/ BUILDING BUILDING ADDRESS / S9 _5/0,,,,_5/0,,,, �rt'iV fd'/jy')D fl_ COSTA MESA. CALIFORNIA For Office Use Only I RECEIPT NO. I PERMIT NO. OWNER cca cin-1 Sa COc,,n e. • RECEIVED N MAIL ATeeCEiV ATE IBBU ADDRESS S /h.Ci � � ( / Ice- / EU// CITY NO. BUILDING' /v ! dW �N72yi� / ADDRESS ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. ADDRESS FIRE nn��JJ ZONE TYPE // GR�OU CONTRACTORFtWX't 19/57.S.-4-7-.1.. eL D APPROVED c` I :14- DATE/ 3 -o I ADDRESS2-7�q. �.E/f' - \\\ c-Z'7ONIING tc/ e CITY Co.[� cryit, Esn ZONE // NO. /� BUIUSOF NE (�4-, O ` // I PLANS / •I BUILDIN3. d J� 'SEM. .zP^� /O OI QI NEO. /�-I f-- ,II� DESCAL RIPTIO. —^I�/ C� res t, (�' SIZE /l`/ / ) NO. OF SLOGS. l• q OF LOT L�JC g-\) X /��/� NOW ON LOT A.P.NO. // 7- 0-,y" /- / D USE OF Alovi /o�7v /fE YARDS EVES EXISTING BLDG. S . APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE op CENTER � ---}}-- •J/- CENTER OP STREET �� REAR YARD 2O FRONT 7.., II/ Lqi. �}G . IN. SIDE YARD I LEFT 3 I RIGHT ,/,?` R.SIDE ..S/FT. IN. DESCRIPTION OF WORK L/ L.SIDE 7 ///S�FT. // //I N. NEW I ALTERATION I I ADDITION 1 X REAR 2 LEFT. 9-!O ,'8a/4/ 8j P/i IN./ II MOVING I DEMOLISH I BYPROVED////1 DATE a/(�/ REPAIRI APPROVED/ 0/ BUILDING NO. OF / (5.'10 f SIZE ROOMS STORIES EXTERIOR WALL` I ROOF /(o 7/No//PE.c7 22 �( COVERING S77JC10 COVERING Bo/K �% I �J USE OF BUILDING AND WORK TO BE PERFORMED •� /�}/, 6 .fin/T/O A) ?6" j&�T/cntJ CC �p1TY) /J A [ew.C4a:n -Si✓T!f /Ycr ¢ (�ti^ C 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. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. BUILDING CONSTRUCTION. VALUATION //nn Pil SIGNATURE OF� - PERMIT FEE $ ./r i ._��T^ PERMITTEF /�/ 6> .l.LULG VD N !�(O PLAN CHECK $ J I 11' AUTHORIZED AGENT /124,5g, am/ JSI I/'f TOTAL FEE $ / r OWNER KIIniNER DATE 1/29/81 JOB'ADDESS 1579 San Bernardino (Room Addition) BUILDING PERMIT NO. 51308 - GENERAL CONTRACTOR Owner-bui1d€r DESCRIPTION of WORK r -tion on 46310,49685 AP No. 117-221-10 LOT 10 TRACT 1257 FIRE ZONE VALUE Q' INSPECTIONS Sig Dote TYPE V GROUP I ZONE SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number I Signature • WATER Plumbing L ROUGH PLUMBING 1/R 1/29/Ri 79064 PROP. SWR. LINE n HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS u ROUGH HEATING AND AIR CONDITIONING /ire Q.-/(-p/ TEMPORARY SERVICE OR POLE //ire UNDERGROUND 0 POWER LI ROUGH WIRING Heating and Vent. n q TRENCHES {: FORMS El STEEL REINF. ❑ )/B /29/81 18170 ,---- FLOOR SYSTEM 1= /`V E D BOND BEAM 0STEEL REINFORCE n rt1OI15 SHEATHING ^^ Incomple` . FRAME AND FLASHING Y)S 5•f�Y'/ Cance' LATHING - IN FA--FA-- OUT Ir� S S 5.f4.Vf �_ 5r6 PLASTER. BROWN COAT Date 1�� , STRUCTURAL, FINAL n//T�� Electric o HEATING, VENT., REFRIG. AND A.C., FINAL iY/B 1/29/ 81 48779 PLUMBING, FINAL AND GAS TEST IT ELECTRIC, FINAL BUILDING. FINAL , CPFrIAI RFn'IIPFMFUTS 6920 1/29/81 10:00 TL • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • RECEIV BV PERMIT N° - 5 1 3 0 8 For Applicant ttoJ Fill in Completely —Use Ink 'Only . ' ADIDRESS /s----7g S ( g stmt.. /aJA/_,7L444._(7 A.P.NO. �I '' X / �(, `� "`�/ BUILDING 5-77, D /`e ` n OWNER OR ADDRESS ! ` Q�,� /ChyGL¢'G>� TENANT UNIT OR -MAILING SPACE NO. ADD RE55/]' /S � CITY t„' M • NO. erg vs-- An TR NO (/p LOT /0 BLK. / I CONSTRUCTION �� NEW I ADD ..ALTER REPAIR MOVING DEMOLISH LENDER BRANCH !//r� dAi,Q5,C OWNER `� ADDRESS USE LC.24,0 7/DN VALUE$ /)n ARCHITECT TEL. �/ OR ENGINEER 't La gN/"J" n NO. C ADDRESS aO tl . xi. r ZONE TYPE V GROUP APPROVED CONTRACTOR O/// JQ BY DATE ADDRESS /J TEL. CITY NO. (-1 STATE CITY APPROVED SETBACKS • LIC. NO. LIC.NO. fa SIZE NO.OF BLDGS. (FROM C/L STREET) O. OF LOT NOW ON LOT FRONT FT. Q USE OF EXISTING BLDG. R SIDE FT. V) FSeparate permits are required for L.SIDE FT. • G electric,plumbing and heating work: REAR FT. F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION a Q (�//�� f,�ft�� /y__ ,// /((i17ti/ // / D APPROVED ›"' i W 7�(f7 ! FYY—qCrJQ c�Y ROVED _DATE 114 W _ h • in 0 I hereby acknowledge that I have read this application and state N IX that the above information is correct and agree to comply with 6r all laws regulating building construction, and 1 shall not employ >: Zany person In violation of the workman's compensation laws of i. a• fai the State of California. 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. n the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and th. su licenses re in full force and effect,or I THE PURPCSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt fro the prevision • the State of California Business I VALUATION PERMIT FEE $ /V/n 0 and Professio - Code,D' isio ha er n PLAN CHECK $ en Signature of // • O Permittee ` � • $ TAX $ — LL2 Or Authorized Agent a $ //to / ! _ / TOTAL PAID /Fl U �e 9 . - . I •r X428 2/Ih/BC 16.DD TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATIOI .,I'FOR STRUCTURAL PERMIT . P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED 'PERMIT N 49685 For Applicant to Fill in Completely —Use Ink Only N BUILDINGA.P. ./ --.20--- //--- / O ADDRESS a _ ` 1 .7. A i.• BUILDING TOEWNNAENRTOR IizuTN CI` ADDRESS 15"l9 - ) 3 F,,,NA,2DIAt UNI ADDRESS /rA)g 1 �A/(,� D/AJQ SPACEC N R MAILING / `NO. TZ{ it LOT /O BLK. /n TEL`` 74 ['r`� CITY ♦/ / NO.Pf��/r _ .s�s NEW ADD ALTER REPAIR MOVING DEMOLISH ////''��ll.•// LENDERCiIOgt•1's// Si/1/ASS BRANCH IT�J /J L, OWNER 1aeNNER ADDRESS VALUE BARCHITECT TEL - USE {�/ftO�QN $�� OR ENGINEER Ko N/4T TEI%s.,�'ssl / 1 ADDRESS4 010aOn/C. ALB) 04 ZONE TYPE V GROUP ant//xy'J1r,r' APPROVED •L /.C,/L.pea• BY DATE ADDRESS TEL. CITY NO. o-Fl STATE CITY APPROVED SETBACKS g LIC. NO. LIC. NO. ' W SIZE NO.OF BLOCS. (FROM C/L STREET) L OF LOT NOW ON LOT FRONT FT. Q USE OF 'C4•, EXISTING BLDG. _R SIDE ES- CD LrA I-1 Separate permits are required for L.SIDE FT. C electric,plumbing and heating work: REAR FT. F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION oltA ••t �!1"'M -w� APPROVED Q y�� fY Tin�/_ ifss io APPROVED >0 /�riLpi w� _AV MATE Cd Ist _ es Q I hereby acknowledge that I have read this application and state N C4 that the above information is correct and agree to comply with 04 all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of .Ff4the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UN s ER VALUATION IS FOR CO Chapter 9, and that . 'censes are In full force and effect,or I THE PURPOSE OF ESTABLISH! G A PERMIT FEE ONLY: to am exempt from a provi ions of t•' State of Cal' ornia BusineAs 4 VALUATION PERMIT EE $ and Professions •de,Divi- on3•te� - Qu v+ m PLAN CHECK $ 0 Signature of C Permittee A I ! ( LL or �• .. i -__%r� — TAX $ u Authorize. Agent •- TOTAL PAID $ /