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HomeMy WebLinkAbout3143 SAMOA PL - Building Permits . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MM,, CONSTRUCTION PERMIT ' T PERM"T O. TRACT NO. LOT NO. UNIT NO. 3frio 4r ?oa. 9 3D 8376 4/173/" 7 Projecl�.ddress r r�y TYPE OF CONSTRUCTION ❑ NEW L I ADD U ALTERATION IJ 'REPAI R Owners NasMailing dr ss -+Jgo&IS El CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone _ Owner's NameQ _�� - } Phone Igo& ./ DESCRIPTION OF WOR K/USE OF BLDG. S Main Building: Accessory Building: Address C f �f[� - ' L Arch/Eng. License No. - TYPE OF PERMIT ❑ GRADING L_yr OUNDATION U STRUCTURAL E Front Q Address ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL BRear N Contractor's Name rived< P/ ,n,uhpie Phonelin000') A❑ OTHER C Right N �s ,y/ a PROJECT DESCRIPTION SQ. FT. OCCUPANCY 9 Address(mailing) K3') ` •] ����� , CON ST RUCTION TYPE VALUATION$ $ Left G City License No. 35 - — ZONE GRADING CU.YDS. ACRES - R LICENSED CONTRACTOR DECLARATION Ping. Ref. # Parrking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:. Planning Notes: RECEIVED APR — 5 las M with section 7000) of Division 3 of the Business and Professions Code, and - my license is in tuff •rce and effect. - - . T License DI.ss L- icense No. 1 • S Date - - WO Signature direatril - _, -it., - - ,, .• PLUMBING FEES WORKE'S' C•MPENSATION DECLARATION • ' . • Bar Sink Showers I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES I of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. ...,,C)q IIAutomatic Washer Transformer 0 15.50 KW Policy No. ./_`��34- -$3 Company 1.„5,171.56°-• ft - . • Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+ KW ertified copy is hereby furnished. ..e Cerf)f'ed c��Qpppy j�filed with the city B Itli g i ision., • Bathtubs Sewer Connection Cooking Unit Meter Duo tO 100 amps Date & .1a. K[) Applicant ��6�= - - EXEMP ION FROM WORKERS'COMPENSATION DECLARATION . y 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 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 El 0-1 HP ❑1`h-8 Workers' Compensation Laws of California. — Date Signature I Floor Drains Swimmin Pool w/S a NOTICE:If,after making this declaration, you should become subject to the — g P F.A.U. Inc.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. ` Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance is g of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater ..! Outlets Lender's Name fff///11, Range Lender's Address Kitchen Sink Water Service Switches - OWNER 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 the Contractor's License Law (Chapter 9(commencing with Section 7000)ofga 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 _- I 7031.5 by any applicant for a permit subjects the applicant to a civil • penalty of not more than five hundred dollars($500). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES License Law does nut 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 ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for BoilerZoning 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 Date prove for the purpose the property,f oe). O t rs owner of the rojectam t7 44, sinesscontracting witholicensedioncon- Duct-Structural Refrigeration System Application Issued By hetors construct the project (Section 7044, to Business and Professions property Cotle: Dat The Contractor'smproLicense Law does not tract to an owner je is hta who Duct-Ventilating 00-1 00,000 BTU 0100,000 BTU SUMMARY 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 Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP . $ - - proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ -�x PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ 5.OV ISSUANCE $ Date Owner _ Heating System& Ducting jisters PLAN CHECK 25% $ ENERGY P.C. $ ' I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BT ELECTRICAL $ - GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of t is city to enter upon the above-mentioned property for inspection pur.j•/', i MECHANICAL $ TOTAL FEE $ 6,5 Signature Signature ns i / ' / Data 3/ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS yft �_ MF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION ANPLANNING POOL &SPA D 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-GUI'IITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd.,Test'-1 9. Water Pipel-Undrgrnd. 60. Backwash Lines, P-Trap, 0 LJridrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line& House Connection 62. Backwash & Receptor-FinalU^ 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 0il 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:CA_9g irAct-4ev (.60 34. Final Heating & Air Conditioning 6frihie tar-Gee-0. G so 35. Final Gas Pipe-Test 7-1 0 alf.0 tCP+r Ouzo c(Q f! 37. Hood or CanopyPr • �/LT/I� �Ir� - 37. Final Facttoryry FFII- jy 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 116, 51. CERTIFICATE OF OCCUPANCY No. _ Date •� OWNER SUMMERLAND LAND CO. DATE 2-28-57 Si 43 JOB ADDRESS .tSamaPlace BUILDING PERMIT NO. N111t66 GENERAL CONTRACTOR Owner Bldr. VALUE $ 10,686.00 LOT 92 BLOCK TRACT 2353 Single res. w/att, gar. GROUP I & J TYPE V ZONE FIRE DISTRICT 4517 PERMITS ISSUED INSPECTIONS ���� DATE SUBCONTRACTOR DATE NUMBER Footing Trench £,--(,4 .'-f 7- cy Foundation Forms and Grade to Garage Rough Framing 4 FF ` / /� '9/5/ Plumbing,Rough to Slab- �5 of y.,>• ', �/_An& ` - - - 4 9/y ✓Plumbing,Rough Complete rn,c 5 6-3-4-7 , Temporary Pole Wiring, Rough JUN - 1957 ' .u. . . • A. .... 41-,-,/4/-s7 999% ✓ Heating,Rough �)e s G-3-J7 a . i - - 997 ✓ Heating,Final h4,e-S D-/S'17 / Sewer, Hou e 5 o, Sewer,St. /d64c :-2G,'J �' N�^ :A ,,, ,.,ate, 3-t(_,r l 4 tr / c Septic Tank or Cesspool Ifi , Lathing, In! OutX. ��/`-' 6 d f. Plastering lsL��,''� " -39 • 7 Plumbing,Final,Fixtures Completae.,j .4-/J=0 \/ Plumbing,Final Gas Test /s' Y✓/G5 /3'47 C' .� �j��� Wiring,Final A /� 'f id-- 7—)>` _ -� Occupancy L a-er-S/ FORM 210 3M 10.55 ill -`' 4s� FEE RECEIVED • COSTA MESA BUILDING DEPARTMENT P.O. BOX 3I'7 COSTA MESA, CALIFORNIA FINANCE DEPT.y FOR APPLICANT TO FILL IN APPLQ�YAQf1C�P�1�C4Nt'APERMIT BUILDING , 3fil3 BUILDING ADDRESS 444 Samoa Place COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. 4416 OWNER Swrmlerland Land Co. 4 /Z• MAIL RECEIVED BY DATE RECEIVED-T tp.ti,E BBUED ADDRESS 112)1 So. 'Rover.] y oz-1d-3 / f ' Lo, 19 TELcrestview BUILDING CITY Los Angeles, Calif. NO. 4M2P ADDRESS ARCHITECT LIC. COSTA MESA. CALIFORNIA OR ENGINEER Williaips NO. 1 FIRE ADDRESS 112b So. Reveal v_T,O s ikrzel es ZONE oumme_ land Land C ZONE NO.DF TYPE GROUP CITY LIC PLA OF CONTRACTOR Co. NO. 6i8 �� 1124 So. Beverly TEOrEgstvXipw APPROVED ADDRESS TI S Angel e, IIAl i f vo y-(11120 BY DATE `EDA` LOT �1 ('� CORRECTIONS DESCRIPTION NO. 02 BLOCK TRACT 2351 A.P. NO. SIZEFLOT V[ 1'}OO NO.OF BLOCS. ONOW ON LOT none USE OF Cr EXISTING BLDG. SETBACK LINE FROM CENTER OF STREET col REAR YARD ?11 I - SIDE YARD RIGHT 22 I LEFT K I DESCRIPTION OF WORK NEW X ALTERATION ADDITION REPAIR MOVING III DEMOLISH NO.OF SIZE BUILDING 1 2 5- ROOMS STORIES 1 EXTERIOR WALL,`St UCC° ROOF domposition COVERING 15C oidinD' COVERING SHI nc1 AA USE OF NEW V BUILDING Sal e Pam 17T Tltapl 1 i n` Pt 9` rt./I HEREBY ACKNOWLEDGE THAT�AVVE AD THIS APPLICATION AND • STATE THAT THE ABO E IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES D STATE LAWS REGULATING BUILDING CONSTRUE• TION. VALUATION SIGNATURE OF w�� w� /�j� PERMIT FEE S 26.C:0 1 PERMITTEE //v'//N4 led e/. \ $ /oi / D ,- PLAN CHECK $ 13.00 (� u b , MF AUTHORIZED AGENTki 4-44TOTAL FEE $ 9.00 1 39 Q'JOB ADDRESS x�3143 Samoa Place BUILDING4PERMIT NO. 42172 GENERAL CONTRACTOR Ai rt 7o DESCRIPTION of WORK Patin Cover AP No.i 39-153-28 LOT TRACT FIRE ZONE VALUE $ 400.00 INSPECTIONS Signature Dote TYPE IV GROUP J ZONE R-1 4SOlL SUBCONTRACTOR PERMITS ISS1ED GAS Dote I Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE n HOUSE CON. ❑ `] SPRINKLING SYSTEM Q MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING • TEMPORARY SERVICE OR POLE UNDERGROUND El POWER El ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS El STEEL REINF.ID FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN [1 OUT n PLASTER. BROWN COAT STRUCTURAL. FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING. FINAL IQ•-G.- 7- 42 ! 72 ' : 21- �..., OO?67U" ^. _ ':z.55G COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only APPLICATION FOR STRUCTURAL ERi1fIT I l C ^ 'EN _ ^ 1 RE I BY AT CEI E D TSI S EBUILDING [/ ADDRESS 3 1 y 1 v/-A '"` op T' � ' �_e0 OWNER 0 l4 A—Ai P A.P.NO. I ,:--3p(/ -215 �R.AM IT NO. MAIL ` ,,t� _ BUILDING 51` / �y _ADDRESS JAy"1 C. ADDRESS � tT \ ' r TEL. y3J LOT L� BLOCK CITY NO. >5j �� TRACT CONSTRUCTION NEW ADD ALTER REPAIR MOVING DgM01 ISH LENDER BRANCH OWNER ADDRESS ���,O ARCHITECT 11_ TEL._ S f!1! VALUE $ OR ENGINEER C l �i•-.l • — ,„ 1•+.4 /\ FIRE ADDRESS I a Ct .Lt /U L_.0 R C V EJ ZONE TV E GROUP APPROVED CONTRACTOR A_ // ,_ F'L h BV DATE// / • 7 • ADDRESS I, 1\ 1 L S �N � VVV_ � --H TEL ZONE NO.OF q USE OF NEW ''' CITY CAr'R Liu A NO Q7 661 % PLANS C� BUILDING Fft-T7i-/'V0, • F STATECITY YARDS APPROVED YARDS APPROVED LIC.NO. kr 6 ply)I + LIC.NO. MAIN BUILDING ACCESSORY BUILDING Al SIZE INO.OFBLDGS. (FROM C/ STR ET) p. OF LOT NOW ON LOT I FRONTPS FT. USE OF _ \\\\/J{�� 1 I .�•1 EXISTING BLDG. ]/t /.� % R,SIDE J,/FT. > FT. 5 Separate permits are required for L.SIDE it,FT. © FT. electric,plumbing and heating work. 07 W _REAR I FT. FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED I DISTANCE BET. BET.MAIN& -� CMAIN BLDGS. ACCESS.SLOGS. �1 y' VAR.*• DATE ', /�TI n C O J a R O Pc-jJ J C.U.P.# APPROVED �.. /44 ,CI t") ILEO -at'SRYPROVED/ }X1' , DATF Vr -p ito a w A. I hereby acknowledge that I have read this application and state N N pa. that the above information is correct and agree to comply with ' all laws regulating building construction, end I shall not employ m Z any person In violation of the workman's compensation laws of 2 WS, the State of California. o I hereby certify that I am properly licensed as a contractor under SQ. FT. H the State of California Business and ProfeulOns Code, Division 3THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: n am exempt from the provisions of the State of California •usW s VALUATION and Professions Code,Division 3,Chapter 9. i ` PERMIT FEE S el—.1 N 1 r �� PLAN CHECK $ coco Signature of� � �- Perm lttea `RF\_z S TAX E a LL U Authorized Agent TOTAL PAID $ y OWNER AYLOR,WILLIAM J. DATE 2-5-59 _ JOB ADDRESS 31)13 Samoa pl. BUILDING PERMIT NO. — 86@o GENERAL CONTRACTOR Better Bilt Fence Co. VALUE $ 176.00 All ko363-i8 LOT 92 TRACT 2353 FIRE ZONE DESCRIPTION OF WORK Block Wall GROUP TYPE ZONE PLAN NO. BF,no • INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Trenches Forms Steel *-f-f 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 w OCCUPANCY �'/ Seo # �lI Form 210-5M-1-57 -- c 8600 / 78-4-V PDT- ,,,oa a*aa*Z.(,,, COSTA MESA /BUIBLDING7 DEPARTMENTP O. I 8E0® COSTA MESA CALIFORNIA 31 :r� . I IT — ''DIVEDFOR APPLICANT O ETEC IN �� C.L. OF STREET t 4 119 0/1 BUILDING ADDRESS #0• / 3 e-q /_ ___,____,_,Rs.,._ LINE _ _ _ FI LANCE DEn Owner (,(,ep-��+'+ tt.:„. / T — — CITY OF CO ' 1F . � �� ,. , / r 10 FT. FOR 60 FT. STREET— 12 FT. 6 I FEl 7 I Mail Addres �50 FT STR ET •City � +-;}�--i2 {�.b O. 00 Ph. No. /l/ 5 9' s tit -4. FICA CO Ph. No. • /7} 9 Addresc 74/.t.. Qpo....4+.._ ez.t . . -C 50FlIIF FRONT City Lic. No. State Lic. No. /6/60 / OF PROP. I- 1 — — t� 150 FT.. w o Size of Lot 47,47x `OOAP No. b err / '11 ?-3 n3 8 1- W A 1 I- Setbacks: C/L Street SO t� /I 3Rer3 aao 'y% W co z b 1/ Left d 1' W CO O: J ¢ a Side Yard - Right co f- `� a. O Type of Fence OA" C/C W a 2 _ u. \ALLEY QR�PR? LINEN a o Y.fP.1'/6,x S41- 8 yds /.%6 /-i O. O •• tocc Z 1 I hereby acknowledge that I have read this application and state • m LL Z ua , • I-- 1 ` that the above is correct and agree to comply with all City Ord- oho t. rplc,' inances and State Laws regulating building construction. Vn�r-- 6 I(^�U Qj. Signature _ /fir — 7 10 of Permittee x. / CCI a U j 1.o I FT Agent 1.: `+'4 �.. -3. 0 H �7 6 I N. ~ FT W 7• - 'i:', F a m �< _ 4o FOR OFFICE USE ONLY z /o V N a FT 1 Patti } p m a — 0 60 FT ST Received by Date Received D su a i i 1 I` i F 1 /"''/e 0 2- --C— a— S / pt2 F T. ST. 2 _,.......-PROP. 1 LI NE __ _ to_ _ _ _ _ _ _ _ VALUATIONen permit Fee $ ` �� O J $ J 7‘ , — Plan Check $ C.L. OF STREETS I ci--0 • 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 r