HomeMy WebLinkAbout3139 SAMOA PL - Building Permits PROJECT ADDRESS: 3139 SAMOA PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 068013
OWNER'S NAME: WIELCH, ROGER E
pRDBESS: 3133 SAI;OA PL PERMIT NO: B 068013 PLAN CHECK NO: N GOVT; N SUPP ; isQ
I COSTA MESA, CA 92626
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STA PURPOSE: ALT
714 ) 546-2656
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF W/COMP SHINGLES SQ FT; 5, 011
ADDRESS: UNIT:
CLAIM VALUE: 5, 011 , 00 CALL—VALUE: 5, 011 , 00 GROUP OCC; R-3 /i•1-1
PERMITTEE: SENTRY ROOFING CO ( 714 ) 751- 7663
ADDRESS: 3364 NEVADA COMMENTS : SMOKE DETECTORS ARE REQUIRED AS PER 91UBC, REROOF 3162SF RESIDENC
COSTA MESA CA 92626 *1:K-****3 *—K)o**t:-*1: 3:-*************y. ):-t. K**#tat:***-********tri.wre:3ET:-*:. 1- •- a, :- :•;:k-;v1:-N-t:-V-3:. -i:. r. r"l's:
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING R EQUIR EMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and felt. SETBACK S
CITY LIC.: 060429 STATE LIC.: 67880? cul . C-39 EXP: 10/94
MAIN BUILDING ACCESSORY BUILDING
7ate,2//Z/W
ORK COMPSON DECLARATION: hereby atfirm that l have acenilicale of cosem toselbinsure or acertificateof Workers' FRNT: FT IN REAR: FT IN FRNT: FT 1N ftEAR; FT iN
ompensation Insurance,era cenilied coDY thereat(Section 3800.Lab.CI LEFT: FT IN RGHT; FT IN LEFT : FT IN RGHT; FT IN
OLICY NO.: EXP. GATE:
COMPANY: PARKING REQ: PROV: PARCEL ; 13915327 LNE: REF NO;
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOT E S>
Date: Applicant: *V *****K ******C—******************-V ***********i•-************#***-t-****t:-********t t:*
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMEN TS
I certify that in the performance of the work tor which this permit is issued,I shall not employ a person in any manner so as to become
subject to the v rkers'Cot pensaiL,tion Laws of California. ZONING APPROVED BY ,
/p, DATE;
Date:� y Signature: BUILDING APPROVED BY
N I If.after making this declaration.you ivisio become subject to the Workers'Compensation provisions of the Labor DATE:
Code.you must lonhwith comply with such provisions or this permit shall be deemed revoked. �f
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the perlorrnance of the work for APPLICATION ISSUED BY: ,_ r.
sem H .: i' P i `� DATE:
which this permit is issued(Section 3097,Civ.C). *******KK** *************** -, a ' �' * Re***f'****-Yr*****'Y. .i�.#*t
LENDER: *******K********************n—ry K�xx.ck*nx*t+***#******Y•*Y--******:: K A A*k V-AAP#.*V*t-*?a i:: ?wn
ADDRESS: LEGALIZATION:N F E IpEp :; IR - Q, R I STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'Stale License Law for the following reason BLDG PMT PLUMB INE€-- ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 81. .00 . 50
repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by P LAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE F E E
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S----> 81 . 50 0 . 00 0 , 00 81 . 50 81 . 50 . 00
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 employees.provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED ; 81 . 50 OVER/SHORT- 00
improvement is sold within one year of completion.the owner win have the burden al proving he/she did not build or improve
tor the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN]—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 • 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for Such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware **************3 *********************Z****************%K-****K*K: *V****#4--*+-**i:* K-
that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A I F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 5011 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 011 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES
25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
66
I hereby certify that I have read this application and state that the above information is en M.I agree to c ply with all city and county
ordinances and stale laws relating to building consiruclion and hereby authorize represents'es of this city to er upon the above.mentiened 01 0016386,-00163..
property for insptbn our/poses. DATE: 07/12/94 TINE: 042 81.50
Date:_7 a- i Signature:
Driver's License or ocial Security
64 '45 While—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
1 r
C3TRUCTION AND PLANNING POOL & SPA
APPROVALS Permit# Date r Inspector APPROVALS Permit # Date Inspector
1. ‘Temporary Electrical Serviceor 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 OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 'f /" 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 & Hous&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
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 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing / 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 73/(19 ,� 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat !!! 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter"Final 80. FOOD CERTIFICATE ISSUED }I
33. Final Electric -c- Notes:
•
34. Final Heating & Air Conditioning . -" i
35. Final Gas Pipe-Test ,.;.,,: 59
36. Hood or Canopy �•^
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING .atC,
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.
PER IT NO TRACT NO. LOT NO. UNIT NO. 2462 2/I B/BJ
CITY OFtCOSTA MES CO ST' UC ION P MIT 7.00 TL
Project Address 9, 40 04- ,� a 7 3 g ,
Applicant's Mailing ••dress - -
V l / TYPE OF CONSTRUCTION U NE LJ ADD A TER I N U REPAIR
P ' ❑ CONVERSION ❑ DEMOLISH OTHER A.P.# Zone
Owner's Name .meq'/ to />y�,r�/�� r' Phon• L��44.1 _DESCRIP ON OF •ORK/�1SE OF : DG. �� �- - . , ., t. Ait
-
Address 31 `` /r/��f•1/` AT ., GS mi % S Main Building: Accessory Building:
Arch/Eng. AlieN - License No. r�t E
T 0
TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL Front
Address /�� +� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING Lr/JMECHANICAL B Rear N
l�Il►�f S A
Contractor's Name PP ..free ph,,.JAI; �Y CI OTHER C Right N
. /� /` PROJECT DESCRIPTION SQ. FT. _ OCCUPANCY K G
Address(mailing) �- /_ q-k 7 �—
MI j ' e/I CONSTRUCTION TYPE VALUATION $ S Left
City License No. ZONE _ GRADING CU.YDS. ACRES - R
LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 0M
with section 7000) of Division 3 of the Business and Professions Code, and -
my license is in full force ..d effect. T
Lioecen - 'lass Jr .'cense No.4' S
1 Dat•e i �Ii Signature -./ Aim . - _ ' PLUMBING FEES
WORK'! RS' C.MPENSATION DEC • RATION Bar Sink Showers '
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL •
FEES
of Workers' Compensation Insurance, or a certified copy thereof Section Backflow Preventer Service Sink
' 3800, Lab. 91 �� • Automatic Washer Transformer 0 15-50 KW
Policy No. z-/ Company ' Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW
❑ Certif' d ca y is hereby furnished. •
e f o i Iled with the city I inion. dOrearbthersteathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Oat Applicant s/gy/ey�'Oyryl
EXEM I�RKERS'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 OGas ❑Electric Sub Panel
I crtify that in the performance o{�th ork for which this permit is issuetl, I
shall not employ any person j/f ahy nner so as to become subject to the Drinking Fountains Solar Tank Fan _ Motors❑0-1 HP 01%-8 •
Workers' Compensation Laws a •
Date Signature Floor Drains Swimming Pool w/Spa F.A.U.
Inc.Solar ❑8-15 HP ❑16-15+
'NOTICE:If,after making this declaration, you should become subject to the '
Workers' Compensation provisions of the Labor code, you must forthwith Floor Sinks Urinal Fixtures ,Microwave
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets - Water Closet 'Device Boxes
I hereby affirm that there Is a conslr ti lending agency for the performance Pole Light
of the work for which this p is issued (Section 3097 Civ. C.) Interceptors Water HeaterOutlets Range
Lender's Name
Lender's Address Kitchen Sink Water ServiceSwitches
OWNER BUILDER DECLARATION Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - Garbage Disposal
following reason (Section 7031.5 Business and Professional Code: Any city or P ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry V Tra s , Generator
any structure, prior to its issuance, also requires the applicant for such permit 00.5 KW❑5-15 KW 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 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). 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 1 Reinspection Fee I $15 Issue Fee
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 Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for Boiler Zoning Approved By Date
sale. If, however, the building or Improvement is sold within one year of corn- Canopy Type 11 El •
•
pletlon, 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). •
L1 I, as owner of the property, e elusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Data- •
tractors to construct the proje t Se n 7044,Business and Professions Code:
The Contractor's License o of apply to an owner of property who Duct-Ventilating - ❑0.100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon d ntracts for such Projects with a con-
tractors) license pursuant' h Co tractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration • BUILDING PERMIT $ SMIP $
proof of their Worker's mpensa ti n'insura nee should be provided to me. PLAN CHECK $ PERMIT
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ PERMIT
ISSUANCE $ •
Date Owner Heating System& Ducting Registers ENERGY P.C. $
PLAN CHECK 25% $
I hereby certify that I have read this application and state that the above 0-100,000 BTU 0100,000 BT • GRADING $
information is correct. I agree to comply with all city and county ordinancesp ELECTRICAL $
and state laws relating to uiiding constru n,and hereby auth rite r pre- •--.T/ PLAN CHECK 50% $ MICROFILM $
sentatives of thi cit •: enter upon t above-mentioned 0 per for 60 GYT7/iS
Inspection our•• I MECHANICAL $
�� / �- /8 {n TOTAL FEE $ .......1
Signature Dat Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
Drivers' Licen r SS
CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor - - -
•
•
- CONSTRUCTION AND PLANNING POOL &SPA
-APPROVALS - Permit Date Inspector APPROVALS Permit Date Inspector
"161. Temporary Electrical Service or Pole 52. Pool & Equipment Location
• 2. .Soil Pipe-Undrgrnd. • 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
k�. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding
•
• 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduif-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
13. Roof Drains 64. Plumbing System - Final •
14. Rough Plumbing • 65. Electrical-Final.
15. Rough Electrical-Conduit - 56. Solar System-Final
36. 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 O 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 •
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:2..24.be7, LEFT riot taco •
34. Final Heating & Air Conditioning If-zit-97 C•,g,•, (i5 Pt�•70.3 opt LLj
35. Final Gas Pipe-Test s T vt��c��
7
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer •
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co •
51. CERTIFICATEOF OCCUPANCY
No. Date
OWNER STOLP, JAMES AUG 1 0 1961 DATE 9-8-60
JOB ADDRESS 3139 Samoa Pl. BUILDING PERMIT NO. 12795
GENERAL CONTRACTOR Better Bilt VALUE $ 225.00
ARN0.113-383-19 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Block Wall
INSPECTIONS DATE I GROUP TYPE ZONE Ki-
Underground
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating -
Rough Plumbing J
Miscellaneous QQ t 11'
Prop. Swr. Line House Con. St. Swr. ,.T ct -
Sprinkling System /
Heating, Final Cr1CCo,nt
Plumbing Fixtures e-�
Final Gas Test C
Construction Pole •
Underground Power
Rough Wiring
Trenches,Q Forms' Steel/W-74. q..i 77
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam '
g, Sheathing
rFrame and Flashing _
Lathing, In Out
Plaster, brown coat _
Plumbing Fixtures, Final
Electric Fixtures, Final A
Building, Final kirk,/ grtRA.l Mt..fltw\ rJJ, IISI w41
OCCUPANCY I 0
Form 210-5M-11-59 5-B P 12795
- ;- ` 12795
FEE ., RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT • SEP 6 1960
P. O. BOX 917 COSTA MESA. CALIFORNIA
fOCPT
For Applicant to Fill In Completely APPLICAu'N 06S���
• TYPE OR PRINT FINANCE GTS
pp �/// BUILDING
ADDRESS,?/J /q- i l 2'
COSTA MESA. CALIFORNIA For Office Use Only
` A I RECEIPT NO. I }A IT 5i
OWNER i/�? /e-Y//4 �-G]
MAIL C /I or n RECE3y ev I owrE�- ni 4I DATE. I6,-fe:G
ADOR ,B aS ,�j�L(*�/��l/ q !//i�..�. .f`/ // Y
NG
CITY ( 4n-€ .e- V�FL. TNO,,K cD$ ADDRESS �/
ARCHITECT TEL. — COSTA MESA. CALIFORNIA
OR ENGINEER. �— NO. •
FIRE
ADDRESS JJ,���ff ����� ZONE TYPE GROUP
CONTRACTOR ,./.5../.-e--/2- APPROVED
_On
yJ /, ,,,//. `/9-(Z
BY DATE
ADDRESS _On // ^ / J-re ZONING ///ttt
/- (I / ZONE I NO.OF BUI OF NEW /,/
CITY �� %� L_ PUNS BUILDING Ai(
STATE TEL. LEGAL //` ' �4 '} - /9
i LIC.NO. NO. DESCRIPTION J
SIZE I NO. OF SLOGS. /�
OF LOT NOW ON LOT A.P.NO. d
USE OF YARDS EVES
EXISTING BLDG. _ APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE 8T.) �)
CENTER OP STREET REAR YARD FRONT Jam(/ 74.t.T. IN.
SIDE YARD I LEFT I RIGHT R.SIDE - FT. IN.
DESCRIPTION OF WORK L.SIDE 'P7FT. IN.
NEW II ALTERATION I II ADDITION REAR -0--- FT. I6,;-7)y �)
REPAIR II MOVING I II DEMOLISH BVPROVE4W DATE 6[�
BUILDING NO. OF ��jj��
SIZE ROOMS STORIES
EXTERIOR WALL ROOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
/
. / / L 7 // -- < , ("L j -
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 CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONBTRU N. VALUATION
SIGNATURE OFc�tJ��J7e1:4-‘—‘
!Q / _2� PERMIT FEE $
PERM ITTEP JJ�-���" ! / I/ B
$ • /` PLAN CHECK $ 4
AUTHORIZED AGENT . . o
TOTAL FEE $ S.
OWNER _ STIMtaAND CO. DATE 2-28-57
S Val
JOB ADDRESS ilyee-Samoa Place BUILDING PERMIT NO. i _6
r.
GENERAL CONTRACTOR Owner Dldr. VALUE $ 10,686.00
LOT 93 BLOCK TRACT 2353 Single res. w/att. gar.
GROUP I & J TYPE V ZONE FIRE DISTRICT 1518
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench &-S-S 4 -17 -
Foundation Forms and Grade to Garage
Rough Framing 444 - —• _S 7
Plumbing,Rough to Slab LuqQ .. 5 9 . (710* Ta.•�.f ti G 2/-' 5/-s 7 ?Si/ sre-
-
Plumbing,Rough Complete 72/4$ - - "s.,5' CCII "
Temporary Pole JUN 4 1957 VCB �'�DttL�I
Wiring, Rough l:. .7HC Zle� -t 4 64-441-3-7 'y 'S°
Heating, Rough II g5 . •3-J7 a . fl.e _t_„ ,s -S 9973 t/
Heating, Final m eL 5 Er/St-57 ,/d
Sewer;Ho 6 4 p ii Sewer, St.4m.' 6-1.0.4-2 /9'/u i---..1��.:t - 3-4/-d- 7 (-.9,C,<—
Septic Tank or Cesspoolae t
Lathing, In } outX g...--S-1
t /,�-'.�y
rp/✓/a
Plastering t -'6 Iii 'A9-
Plumbing,Final,Fixtures Complete mY1.c( fist,11%S]
Plumbing, Final Gas Test /S' )4iLS /6(Si �� - xe.% /////7,Th
Wiring,Final27_ -C '
e -' �cA / 7
Occupancy e�=�q��� ,.10..Dyn7 —
FORM 210 3M 10.05
451$ FEE RECEIVED
COSTA MESA BUILDING DEPARTMENT FINANCE DEPT.
P.O.BOX 317
COSTA MESA. CALIFORNIA CITY OF COSTA MESA
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING „ 3/39 BUILDING
ADDRESS" . ^
. Samoa Place
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY '
RECEIPT NO. P�1A�f/PDr
OWNER Summerland Land Co. (��C-/Z(FV�I5
MAIL RECEIVED BY DATE RECEIVED T ISSUED -
ADDRESS 1121E So. Reverly .�--�° a-z(('J7 FES 8 1Q57
CITY TNo r5_I 751N ADDRESS
Los Angeles , Calif.
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR ENGINEER Williams NO.
ADDRESS 11 `�I
11 5'Q_ 13pT.p»lzr-T./�ob nn mel ps ZONE FIRE
ZONE NO.OF TYPE GRO
Summerland Land CITY LIC. [ pJ PLANS "--*-
112b
�
CONTRACTOR (10. NO. 61 85 (�J////y./
112_11 So. Beverly TET S W APPROVED
ADDRESS Las Angeles • Califuo. b.... 0 BY DATE
LEGAL LOT CORRECTIONS
DESCRIPTION NO. q3 BLOCK TRACT 2151
1
A.P.NO.
SIZE NO.OF BLOCS.
OF Loi 61CC NOW ON LOT none
USE OF
EXISTING BLDG.
SALINE FROM ^ I
CEETNBTECKR OF STREET co I REAR YARD 30 I
SIDE YARD RIGHT I LEFT rj I
DESCRIPTION OF WORK
NEW X II ALTERATION ADDITION
REPAIR MOVING DEMOLISH
SIZEBUILDING 1NJ 22)1 ROOMS STORIES 1
EXTERIOR WALL C ROOF
COVERING etlic Q rl COVERING Dn&r it
USE OF NEW
BUILDING Si prrl G Tirgrri 1'VT llyrpl 1 4 nr,
I •HEREBY ACKNOWLEDGE R HAVE READ THIS APPLICATION AND
STATEITYTHATIN THE ABO E TECORRECTAND AGREE COMPLY WITH ALL
CITY ORDINANCES D'STATE LAWS REGULATING BUILDING CONSTRUC-
TION. Al. A VALUATION
SIGNATUR OF /. / // Z PERMIT FEE S 26.00
PERMITTE �L«�a 1. e. �.J '. 41. Y
15 / PLAN CHECK 5 13. CC
exit
/0, o� TOTAL FEE $ .39• OO Pb
AUTHORIZED AGENT ' �f/ (�� �VP/ %
•
OWNER STOLP, JMES DATE 2-5-59
JOB ADDRESS 3139 Samoa Fl. BUILDING PERMIT NO. 8598
GENERAL CONTRACTOR Better Rult, Fen CP CO. VALUE $ 6110.00
ApH47 8-3-19LOT 93 TRACT2353 FIRE ZONE DESCRIPTION OF WORK Block -Wan
GROUP TYPE ZONE PLAN NO. 8598
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel
Floor System
Steel Reinforce Chimney Re-Rod
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 �5. 3 -7 -a f _
Form 210-5M-1-57 8598
e COSTA MESA BUILDING DEPARTMENT v 1 I
FEB-4-5rP070, 2081 *****4.00
P. O. BOX 317 . IL (6. CLIVE 8598I COSTA MESA CALIFORNIA !�V 61
F°B 19 FOR APPLICANT T FILL IN
C.L.• OF STREET) F NANCI DI PT. Cu re
I BUILDING ADDRESS 3
CFI ' Qc (;i'TTI
MESA
Owner ((��ltert-
r_ ____ _____-aRsp_ LINE _
10 FT. FOR 60 FT. S REET 12 FT. 61N. AOR i 50 FT. STREET I
Mail Ad rest J/3 7 — t rneci--
P /2.1
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I I I I City 6 w Yt1✓//a' Ph. No -S OU e?
{ • I I • Contractor BGG^ `e'Ph. No. 84;_c7fief 79
I I I Address 7s'/� -daa.d2 ,./ at - j '
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50 1IIF FRON City Lic. No. State Lic. No. /6/0 0 1
IOF PROP. F — //
150 FT w tx Size of Lot 6 I X/ o b AP No. Lcffq 3 r�>8
F ' 1- Setbacks: C/L Street 50 ' 1/3
Rear coia '
W ZI m a Side Yard - Right 0 �� Left D il
a ccpf / ,//
y r---- IL v Type of Fence /D/o Gds (l/ae-•
/� A 'L /t
w ALLEY OR PRCIP. LINE 01 p 97 ai sl ose4 .C/ Work_ 3/111 .4,1tc-
o. (_al /
1=-': a '1 I hereby acknowledge that I have read this application and state
ti cot u 5 a . u ' 1 I that the above is correct and agree to comply with all City Ord-
..i
111 = _� �' ~ inances and State Laws regulating building construction.
1 a
{�- „p a t w W Signature �j�j�,��
y1' 9 c >]E- v Q Q ` f I of Permittee �r -"— ` '? —
Q •, : w C\S' FTI I Agent
i.�. `_ o =
57 F T. 6 m 1 F- 0 4 o ' " I 40 I FOR OFFICE USE ONLY
F a. w Z
= �4V U m 5 I FT •
Permit No.
• J N a I
a a• I 8 593
0 on I 60 FT ST. I Received by Date Received{ Date Issued
a. p 1 r'— --i ----77,1--r .2 — S-117c,?-5--,57
`' 9
50 FT. ST. I . I I �_ S `s"
PROP LINE 1L 1 I VALUATION ac-0
— —��— =-- y-- -- - - 1 J / Permit Fee $
in
-
t 9O' d a Plan Check $
C.L. OF STREET—.
•
TOTAL FEE
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