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HomeMy WebLinkAbout1120 SANDI LN - Building Permits ADDRESS OF WILDING: 1120 SANDI LN UMT: ^ CITY OF COSTA MESA — BUILDING PERMIT OWNERS NAMEIF MOWN: PERKCAMMGMT. CO. , INC, . \ ,• . PERM NO: B 079898 mmss, 800 BROOKHURST ST #2A ANAHEIM PERMIT NO: B 079898 PLAN CHECK NO::;,, ., N GOVT: N SUPP : N CA 92804 ( 714 ) 956-2012 APPL.MMUNG ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: 0TH ' ARcxIIECT OR ENGINEER: UC.NO.: JOB DESCRIPTION T/O EXISTING ROOF/REROOF W/GAF30YR COMP SQ FT: 3, 200 ARCH.OR EN.'S ADDRESS: WE; CLAIM VALUE: 3, 200 . 00 CALC—VALUE: 3, 200 . 00 GROUP OCC: R-3 /U-1 caNmACTaRSNAue J.D . JONES ROOF CRAFTER ( 714 ) 826-4827 CONTRACTOR'SMNUNG 6011 SAN YSIDRO COMMENTS : T/OFF EXIST.APPLY NEW GAF 30YR COMPO ROOF/INCLUDES 1122 SANDI LN ADDRESS: BUENA PARK CA uc.No.: 435996 ******************************************************************************* 90620 ural: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing withttion 7000)of Division 3 of the Business and Professions Code,and my license is in hp force and effect. CIrvUC.No.:2'{2.naj LIC.CLASS: C-39 UC.NO.: 435996 EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN — Date: /D—/p- 9/n contractor LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty rjury that I em pt from the Contractors License Law for the • olbwirg reason(Section 7031s Business and Professions Code: ny city or county requires a permit to construct alter.improve, PARKING REQ: PROV: PARCEL : 42204201 ZNE: REF NO: mash,or repair any structure,prior to its issuance,also requires the applicant for ch permit to file a signed statement that he or she PLANNING NOTES> licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of nor more than five hundred dollen[S5001). ************-******************************************************************* ❑ I,as owner of the property or my employees with viages as their sole compensation.will do die work,end the stmcture is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered ler sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of property who buids or improves thereon,and who does such work himself or hese*or through his or her own employees.provided that such improvements are not intended or offered for sale.I.however,the building or improvement is sola within one year of completion,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). o I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business and BUILDING APPROVED BY : DATE: Professions Coda:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contrador(s)licensed pursuant to the Contractors License Law). �) • . . ] / o Iamexemprunder Section: B.AP.C.for this reason: APPLICATION ISSUED BY: 1�E7 F3�1 DATE: to e0 fl ************************ a**a S ** td 3t1t**************** *** **** Date: Owner LEGALIZATION:N F E E S MM R Y STRUCTURAL SEGMENT:Y I do hereby certify Nat I am aware of and understand the requirements of California Health and Seday Code Sections 25505,25533,and 25534,and that I or any future building«apant will I will not(circle one)need to comply with said state codes and the requirements ler BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e permit for construction or modification from the Ak ouakty Management Distdd.Residential constwion applications are exempt from these Provisions. PERMIT 87 . 25 . 50 Date: Applicant SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dadaretims: ISSUE FEE o Ihave and witmaintain acertificate oconsenttoself-insure for workers'compensalicn,asprNmW provided BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.f«thpedomaKeathe w«kfor which tmmat this permit wTOTALS----> 87 . 75 0 . 00 0 . 00 87. 75 87. 75 . 00 11 I have end will maintain Sectionworkers'compensation insurance,es required by Sen 3700 of the Labor Code.for the performance of the}C work for which this permit is issued.My workers mm len insurance carder and policy number are: • Canier: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 87, 75 OVER/SHORT: .00 Policy Number: 285-96UN1100243 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK . (This section'read not becomplas(I1the permit ifor one hundred dollars/$5W/orless.) 87 . 25 . 50 ❑ I certify that in the performance of the work tor which this permit is issued.I Mall not employ any person in any manna so as to become subject to the workers'compensation laws of California,and agree Nat E I shoeld become surfed toth workers' ******************************************************************************* compensation provisions of Section 3700 of the Lacer r forthwith comply • three° IND IVID UAL F E E BR EAKDOWN Date: /09--/d4(40(40 Applban. Wanting:Failure to secure workers'compensation covers•- n/awful,and Isubject an employs to criminal mettle and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines tm to one hundred thousand dollars($104••• addition to Na t of compensation,damages as provided for In Seddon 3706 of Na Labor Code,Interest,and attorney's lees SFR 3200 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 200 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of Perkins.that there is a corstnidion lording agency for the END OF FEES perl«marca of the work for which this permit is issued(Section 3097.Ci..C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have mad This application and state that the above information is correct.I agree to comply with all city and county ordinances and state lawn relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property • for inspection purposes. JENNIFER HAUSER • Print Na� 01 00216784-00216785 TOT 87.75 �� 741on Dae: /�1/��g� DATE: 10/10/95 TIME: 12:04 reg a GwnedAgentrp akL tractor (5151.4e.WP) White-Building&Safely:Green-Fie;Canary-ApplicanC Pink-Revenue:Goldenrod-Assessor - ti - POC. . SPA CONSTRUCTION AND PLANNING _ 7 Date Inspector • - Date InspeCto/; APPROVALS Permit 4 - APPROVALS Permit 4 - - ` • 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 4 2. Soil Pipe-Undrgrnd. -- 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Ugdrgrnd. ' - 54. Forms T - 4. Electrical Conduit-Undrgrnd" ;; 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test T - 6. Electrical UFER Grrid. 57. APPROVAL TO COVER-GUNITE t 7. Footings 58. Electrical Conduit-Undrgrnd. • '; 8: Foundation -59. Gas Pipe, 0 Undrgrnd., Test, ,/,' .. h 9. Water Pipe Undrgrnd. • . i 60. Backwash Lines, P-Trap, 1 Undrgrnd. 10. Structural Floor Systema 61. APPROVAL TO DECK '11. Property Sewer Line & House Connection - '62. Backwash & Receptor-Final !, '' 12. Sewer Cap I . . 63. Heater & Vent-Final 'I 13. Roof Drains ' 'I -64. Plumbing System- Final 14. Rough Plumbing 65. Electrical-Final ; 15. Rough Electrical-Conduit -1 66. Solar System-Final '1 - 16. Rough Electric Wiring . 67. Fencing & Access-Approval = • 17. Rough Wiring Sign 68. APPROVED FOR-PLASTERY NG 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-. 7., . 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &'Test72. Underground Flush - 24. Roof Framing - _ --I - Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof'Sheathing _ _ /U'f`�C( / it /////"� 74. Overhead Hydro 26..T-Bar Ceiling (Structural) & Monocoat ( / 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe_ - , 28. Lathing& Siding' - 77. FIXED-SYSTEM FINAL ` 29. Insulation _.- 78. FIRE PREY. FINAL - 30. Drywall Nailing • ' - ';:, HEALTH DEPT.-REQUIREMENT 31. Plaster Brown Coat ' _ 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final - 80.80. FOOD CERTIFICATE ISSUED 33. Final'Electric - - - - • - Notes: • 34. Final Heating& Air Conditioning -) (4 1 - _ - 35. Final Gas Pipe-Test /• - T ' 36. Hood or Canopy • .. _ - • 37. Final Factory Fireplace P - - _ 38. Final Plumbing - - -' - 39. Water Service-Final `� - t. 40. Gas Service-Final ` . _ 1, , 41. Solar Domestic-Final - 42. Backflow Preventer- • - •. 43. Backflow Irrigation. - - - - - 44. Landscape Irrigation System - - - - - _ - . 45. Sound Attenuation • 46. Handicap Regulations - • • • - 47. FINAL STRUCTURE & BUILDING i/(j i� - - 48. FINAL PLANNING. - / - .- 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51.. CERTIFICATE OF OCCUPANCY No Date • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. - TRACT NO. LOT0. UNIT NO. �►ao SAL'ti Li)' 13 3285(0 �13P> I 1`i- Project Address p rr II ' t's Mailing Address •t,x31-[= }.1/JLQK�2t/1►.�_ TYPE OF CONSTRUCTION U NEW LI ADD C ALTERATION CI REPAIR Applicahf• r t�� CI CONVERSION III DEMOLISH ❑ OT�x R� + 1 �/ �7 s 7=41 !f Owners Name Iv'►—PTIAINJ Phone 452-251// ,yCy L-l'ak1T IPJ LtUr R A.P.#.(�LZ_— O�"Z-%-_. vl(+Q ( Zone l'J -�'-(1� t• o DESCRIPTION OF WORK/USE OF BLDG. UNa+ D'J"`— v Address ► ►20 SA..11)i L N S Main Building: f'� �p Atcecsp7y Building;_ Z Arch/Eng. �' ' License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION '8TRUCTURAL T Front. '' BF,� th O Address Cl TENANT ❑ ELECTRICAL 'CI PLUMBING ❑ MECHANICAL B Rear , , v - 1�d ;, N Contractor's Name CAGF . VK�7L Icutt Phone BS L-kS\ ❑ OTHER A i ���•l` .V .�Q p'' I ' PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right ' 'f , G Address(mailing) 1�� 1-� 7/G���r-.s, _Ito)NL3 /,'� K , 1�7F ` 'h CON STRUCTION TYPE VALUATION$ GO - — s Left ' \a`E•-, / R City License No. �-7 �Y1 r7 ("i4 ZONE GRADING CU.YDS. ACRES Pin Ref.# Reyy,,� ttE LICENSED CONTRACTOR DECLARATION g' Parking 9.7YI'bVed D I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ,L W 1 1�LJ1 t5r ]L4 ) t� Planning Notes: 9/�wl1 M with section 7000) of Division 3 of the Business and Professions Code,and ILl �-1 rl s_fy..J "�'�I T my license is in f rce and effect. •�' �((�'p License Cass -� i Li J-nse No.3 s+ • • 5 $ Date •` - T Signature SW' _ �...i. PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink ShowersELECTRICAL 'FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 00, Lab. C Y G a Automatic Washer Transformer D 15-50 KW :otic No. $170/ f Company t C)' ' Backflow Irri ation ' - D 50+KW Y P y 9 Sewer Cap Construction Pole Sub. ❑ Certified copy is hereby furnished. Ce t,}fie op9i Jtied with the city B ygav}'$1on..� Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 1��'YY Applicant 11•�J 211 ' EXEMPTION FROM WORKERS'COMP NSATION 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 ❑Electric Sub Panel , I certify that in the performance of the work for which this permit is issued, I - - - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. _ coate Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ - YJ NOTICE: If,after making this declaration, you should become subject to the \ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this' permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet ' Device Boxes Pole Light 1 I hereby affirm that there is a construction lending agency for the performance _ of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Interceptors Water Heater Outlets Range r -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 00-5 KW 05-15 KW Trash Compactor any structure, prior to-its issuance, also requires the applicant for such permit 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 Section 7000)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 - 'penalty of not more than five hundred dollars ($500). $ 3 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee 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 MECHANICALFEES - License Law does not apply to an owner of a property who builds or improves DEVELOPMENT SERVICES REQUIREMENTS: thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ employees, provided that such improvements are not intended or offered for- Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By _ Date rove for the purpose of sale). C --ewe 1. LJI, as owner.of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By � - - Date -1,_-' U 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 • SUMryryryAYfIIl,,,���G�RY OF FEES builds or improves thereon,and who contracts for such projects with a con- - _ 1 IC - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration - BUILDING PERMIT $ SMIP $ ,_J)S�. - proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ ►2 PERMIT - • • 0 am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Da mperi I 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 0o-100,000 BTU D100,000 BTL ELECTRICAL $ GRADING $ _ information Is correct. I agree to comply with all city and county ordinances " • and state laws relating to b • • con uction, and hereby authorize repre- PLAN CHECK 50% $ r.'� MICROFILM $ seLives of this ci upo the above-mentioned property for Infection purposes- MECHANICAL $ TOTAL FEE $ 3'CSC • Signature 4 '� "'' Date u-� ly Drivers' License or SS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $- CMF Odb -46,rev,10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor Ulla . • CONSTRUCTION AND PLANNING POOL&SPA 'APPROVALS i Permit Date Inspector APPROVALS Permit# Date Inspector i'.- Temporary Elect[ical-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 COVE R-GUNITE ' 7. Footings 1 • ,s 58. Electrical Conduit-Undrgrnd. 8. Foundation(. _ i:I j,tt. -•- - 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 i 13. Roof Drains 64. Plumbing System - Final , 1 14. Rough Plumbing _ 65. Electrical-Final 1 15. Rough Electrical-Conduit66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING ' r. 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ( 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT I • I 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure' 70. Underground Hydro .77 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 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 ,.,r- - 29. Insulation 78. FIRE PREV. FINAL .._ - 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION ;� ' 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - ' 34. Final Heating & Air Conditioning • r: • 35. Final Gas Pipe-Test • 36. Hood or Canopy - - `-I 37. Final Factory Fireplace •; i<' ' 38. Final Plumbing ; ' t 39:Water Service-Final i 40. Gas Service-Final - - ' • 41. Solar Domestic-Final �, f ' 42. Backflow Preventer • Ti ' ,' a _s 43. Backflow Irrigation - •1 ' -I- . . IN -44: Landscape Irrigation System •` 45. Sound Attenuation . ` -- 46. Handicap Regulations • �1' - �� 47. FINAL STRUCTURE & BUILDING f{ ms, id-- � . ''., , 48. Special Requirements Completed - • , -: • 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co - • 51.J ERTIFICATE OF OCCUPANCY • - • No. ' -.7 Date _ - - - _ i. t - ' t. - , . . li ci. /.4-/c K-C>c3•en SKYLIGHT THROUGH CATHEDRAL CEILING a S7 x44 Bristolite Skylight Metal Flashing cm I.C.B. O. 2469 & Waterproofing mmi 6 ei .ci IMmOD (-) 4 47 A000111111.P.- ;a.: La = ! > CD E 37 )1 Imml t 1. : 4 bg I LL"! Ca R Lig -2_ x13 Roof Rafters: /6"0. C. w 77:71 , ---. Cd r-:--- . R riThn:n.% e el-) =in cc . A ie rh-Livt ,.,,itt 2C a CC ,cg City of Costa Mesa Building. Dept a < a BY —_ 5a _ . DATE 4'44/ 19 ea.' I THESE PI 4:•!.5 l'AUST Br: 0•: 10B AT A!,i.71:::BS .‘ :;.< ! 1.= >- mime NC NO C.HANIC“:.i 'v.'r C-!.T t7-107 AP?ROVAL 0: DEP I_ - EA w ICE ii 1332;bl:tie Com, r • -,?. E0q-DBEA _.......er"'"-""••••••. . oaor _ ' . . ,,. :',..5 :F zoo- Ru if1/43C0 . Ak /at-Tr/C-2S (leer '1 ocibime..e.- //cAb 4 Side 41/4- n°' -' ''' -'- - SKYLIGHT ADDITION,JORI 0.: i; e• .z., ..:::,- R.do .5 e,.. .. ri.::-.1": D , T: %, ,.,n tin-fey , . -• -' ' •-:` C: '. CEOf 4 7 . . -11 SkiA):b1 L40/ ... . • /ho ga...<77? 717C-C-4 iir 7c9.1.- 9:50C -, 'A . City of Costa Mesa .ting Department • Post Office Box 1200 • 77 Fair Drive • jj�� Costa Mesa, California 92626 ui t t tjt d (714) 556-5245 REQUEST FOR OCCUPANCY (Single Family Residential or Condominium Units) • • Tract No. _ 91/438 / Date rr - /5- 72 Lot No. /z Address f/a0 £ qnd. /s,,e , Ca 5,7— /77es� o • The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he, she, they) 7 By (was or were) kke6 advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was approved. • • The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to.indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. • RECEIVED By �� wan CITY OF COSTA MESA � PUNNING ^ I�' EPT. By Jar Y 'wI ' AUG 1 5 1977 Developer an.'"•7ut :rized AM PM Representative 7 1819000.102i1 12131415 6 / Len. ;air-a' CMF 0569-26 �� City of Costa Mesa ling Department • Post Office Box 1200 77 Fair Drive -1 �� Costa(714) Mesa, 556-5California245 92626 COS flit REQUEST FOR OCCUPANCY (Single Family Residential or Condominium Units) • Tract No. 9.72'/ Date P -/S- 77 Lot No. / Address / /2i SAnd ' A r3 e LosTr / esa The developer of the above entitled tract desires to sell the above • set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he, she, they) 77)e,, (was or were) Gdets advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the • City at the time the final tract map was approved. ' The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. \ s `' —4 RECEIVED / CITY OF COSTA MESA By r *% PLANNING DEPT. AUG 1 5 1977B `��� tat AM PM y ' GTeloper . d or Authori ,• 7181911011102111213141516 �tarive 4 By Le /44.....eleA ,`I CMF 0569-26 � � �J OWN ER PROPERTIES WEST, INC. DATE 10-14-76 N JOB ADDRESS TlZ0, 1122 Sandi Lane BUILDING PERMIT NO. 40621 • \v GENERAL CONTRACTOR Owner/Sldr. DESCRIPTION of WORK Duplex w/3 Gars. Cke AP No. 115-031-17 LOT TRACT FIRE ZONE VALUE $51,000.00 \INSPECTIONS Sinature Date TYPE V GROUP I & .3 ZONE PDR-MD SOIL 2'- .z '5- 7z. SUBCONTRACTOR - PERMITS ISSU D J GAS aI• 7y� "J• C.72 Date I Number 1 Sianoture I(((WATER 4 G. t9 . ) 4 2. �/7 +r' �I Plumbin. ROUGH PLUMBING J S 3 ./7.77 n �7/�h_' . PROP. SWR. LINE Q HOUSE CON. .25--77 • I e r �: , . l$t ?4- AV -3i'7 SPRINKLING SYSTEM ! 0r�7`7, 70,u39 MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING Z i 3 3S 27 - TEMPORARY SERVICE OR POLE • UNDERGROUND n POWER 0 ROUGH WIRING , /-7 Heatin• and Vent. TRENCHES O FORMS ❑ STEEL REINF. ` le C _.:ii, • C ,. 21 • -.4c...a -2,/-77 / 6" ^0.'"— FLOOR � FLOOR SYSTEM t♦(n` / 11 .71 'rig/ £h,rt.. ` 3-2-Y 11 /.37.02".....-- BOND 3706 BOND BEAM n STEEL REINFORCE n 1., , SHEATHING . sel-�•77 FRAME AND FLASHING • p �*0 3-29. !/ LATHING — IN n OUT n INSLL'RI- 7.•1.L17 PLASTER. BROWN COAT STRUCTURAL, FINAL Eleert/�/'I� HEATING, VENT., REFRIG. AND A,C., INAL t$ K�J//JS II It 77 / L�/JYL�J� �FAA/ 51- V/V//e".---- PLUMBING. FINAL AND GAS TEST Y N y i ELECTRIC, FINAL = / BUILDING. FINAL 4-06 SI 11.1-76- 00:i 836 El*** 178.00 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP LI AT N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RE IV D e'( DATE RECEIVED BUILDING 1 itlig y w0� L, \ y DATE ISSUED. ADDRESS 20 t �J pEaT►ES 1 r- r Ipc- PERMIT NO. OWNER A.P.NO. MAIL BUILDING II2o 4'I 12z ii 1 ` ADDRESS ADDRESS Lu TEL. CITY NO. TRACT I LOT BLOCK CONSTRUCTION NEW ADD ALTER1REPAIR IMOVING DFMOI ISH LENDER BRANCH �{� '/ OWNER PGI L�E; __ ADDRESS n /t VALUEr ARCHITECT TEL. US �'4ers- L $ OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE NO.OF USE OF NEW PLANS BUILDING CITY NO. STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING La SIZE NO.OF BLDGS. (FROM C/L STREET) L OF LOT NOW ON LOT FRONT FT. FT. Q USE OF EXISTING BLDG. R SIDE FT. FT. Nl 9Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. ClREAR FT. FT. [.., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& QMAIN BLDGS. ACCESS. BLOCS. /) VAR.# DATE in 1A/P 614 A.Vic???/� C.U.P.# _APPROVED >- APPROVED >., BY DATF tJC H.1 0 I hereby acknowledge that I have read this application and state In tY, that the above information is correct and agree to comply with L all laws regulating building construction, and I shall not employ m Z any person In violation of the workman's compensation laws of E suthe State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. 't the State 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 from the provisions of the State of California Businessto a end Professions Code, Division 3, Chapter 9. VALUATION PERMIT FEE $ /7 ,r 1 .t / `�N PLAN CHECK $ Signature of 0%, Permittee $ TAX $ V u Authorized Agent ,. TOTAL PAID $ 1 i y _- PA;L' O 1 ` -..140621. SEP 30-7r1;=cO01379* x`irk{;9 ,.07 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AFor Applicant to Fill in o •letely—U Ink 1 nl E j A r ON FOR STRUCTURAL PERMIT =_ I _ _ _ RE.i •, E RECEIVED DATE ISSUED BUILDING / — J -r '-oO-t_.. . ADDRESS :Si•.rsa.„._:..S7._ra__ _ / / / �,/� - •• OWNER � :�.. ••=.- = -i A.P. NO. -lJ� Ilia 7/■ MAIL /� Hers' ^^ - BUILDING '� / F ADDRESS I OJ /•C'/�L`e . /'r ADDR" ��\\ Si�(��� `� CITY / r Q�t I, -x:42‘..,0,(0:42�. (Q TRACT`5 T LOT,10 O BLOCK CONSTRU 10 /' "`" nNEW/ ADD ALTER REPAIR MOVING DEMOLISH LENDER ! �' BRANCH Pet �7 A OWyi E R / rel: :I.' �6`5 .j ��/ ,-//- ADDRESS �]ea �! VALUE ` }� ARCHITECT �/� /f�//�/7 TE jJ�_9j US �'���'` `J t 2 $ e� ©t7 V OR ENGINEER O•!as"IT�//Lf.WI'� N0�4�"(J/k - / /J FIRE •-� ` ADDRESS -.`� vA ZONE T PE GROUP I� '-1 r APPROVED II U1 �J CONTRACTOR j � // BY 1 DATE 10 - (1.- . ADDRESS N - .....e/e4' — TEL. ZONENO.OF USE OF NEW - CITY NO. r _no)) IPLAfS 4- BUILDING (e. 1'Tr GAR. F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. 4 LIC.NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L ET) IR SIZE /. NO.OF BLDGS. r 0. OF LOT / 0 a�, NOW ON LOT r PONT i.e. FT. .d t . As " co USE OF //`/_ _ s/ 1- EXISTING BLDG. fs/'/'/��Yp�'_- /i �� ��'` R,SIDE FT.btCJ . /SFT.con / T Separate permits are required for €SIDE FT. � '� ay. A). O electric,plumbing and heating work. REAR 5 FT. FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& ' xt MAIN BLDGS. ACCESS.BLDGS. V Q r. CUP.# 1 �n5_,./"APPROVED IO -7-7 .>.l _ tifalla-atit.nd./Y7 /jJ.GI APPROVE Cyp/. I 1(1)6" r (J" DATE 1D`/pZ /�J m CC// -(OLD FORSPECIALREQUIREMENTS CI hereby acknowledge that I have read this application and state n ce that the above information is correct and agree to comply with - m 6i all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of e TTWrr the State of California. //nt` �t I �j ,� 3 I hereby certify that I am properly licensed as a contractor under ` T D 50. FT. •.+ y �/wK Zr0 N the State 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: e am exempt from the rovisions- . tate of California Business VALUATION PERMIT FEE $ a. and Professions Cod iv on 3, -.• f o M / ii, 7r PLAN CHECK $ rrJ PermitteeSignature of .r $3/ODO TAX $ 1. t7 U Authorized Agent TOTAL PAID $ it. 07