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Home My WebLink About1071 SAN PABLO CIR - Building Permits 41 CITY OF COSTA MESA 41 BUILDING DIVISION :r i.,,,. �. DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1 ��s. I - �•.y� . PERMIT E01-00033 masa (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1071 SAN PABLO CI Status: ISSUED Suite No Applied: 01/11/2001 Vicinity: KITCHEN Issued: 01/11/2001 Parcel Nunmber: 41206114 Applicant: JUREKOVIC, JIM ISSUED BY: Address: 120 BROOKLINE LANE Phone: (714)540-5417 COSTA MESA,CA Zip: 92626 Owner ROBERTS, WILLIAM P TR Address 1071 SAN PABLO CIR Phone: COSTA MESA,CA Zip: 92626 Contractor: JUREKOVIC BLDG CO Address: 120 BROOKLINE LANE Phone: (714)540-5417 COSTA MESA,CA Zip: 92626 License: 548410 SCOPE OF PERMIT SUPPLEMENTAL ELECTRICAL PERMIT FOR INSTALLATION OF 9 LIGHT FIXTURES&4 SWITCHES IN KITCHEN. REF: E01-00004 FEE SUMMARY Quantity Quantity • ISSUE FEE $7.25 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $9.90 9 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $4.40 4 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $21.55 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. i 7 FOR INSPECTIONS CALL: (714)754-5626 v 2446-46 WOO) aralliMillMIMIMMIIMIUMa WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'cdmpensatlon insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed If the permit is valued at one hundred dollars($100)or less.) •I certify that in the performance of the work for whi J his permit Is Issued,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of Califoml: and agree that if ould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro ' •n O_ - 1-< ( -0 -APPliient Signature:" _ �-Date: - - ThOUS-WARNIAN: DLLA E(TO SECURE WN - zioN TO T '' COVERAGE TIS UNLAWFULMIASPRLLIDED FOR AN EMPLOYER 7TOFCRIMINAL LABOR CODE,INTEREST,AND FINES UP N ONE HUNDRED . THOUSAND DOLLARE(5100,000),IN :•TION TO THE w OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 370a OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I_am licensed under provisions h ter 9(commencing with Section 7000)of Division 3 of the Business and PjGfessions Code,and my license is In full force and effect.Lic.k T) '' l 0 Class P-- ' Contractor's Slgnetu�e: (7tra -ti Data;- - - ' ( 1-p CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is 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.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(5500).): ❑ I.as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Drivels License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or Present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gae at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greeter than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3_...._.. will the _ _—_ _...�_._ _ _. 3 Does or will the applicant or Present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a armit for such construction or modiflcatIon from the South Coast Air Quality Management District or from any other air pollution control district or agency? IU Yes j�No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes`,the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). - 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No _ _ __..e — __.... _l.__- _—__._ __...__ 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ' e Sig re a1 Owner(s) I Date And/Or ed - plicant - I ,-Date . ;ODE I, ILSPE �PE DA3 =au cant INSPECTION TYPE 126T1 IM®t)l$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing �jI' 200 Final Re-Roof 210 Final Electrical ///G/C/ f„EL, •vl4T- 201 Final Block/Retaining Wall 212 Final Fire Prevention _ / 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy - 4`p5�Mf 9 - CITY OF COSTA MESA • an BUILDING DIVISION Fc , DEVELOPMENT SERVICES DEPARTMENT PER T NUMBER PERMIT 01-00004 min (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us • 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 1071 SAN PABLO CI Status: ISSUED Suite No Applied: 01/02/2001 Vicinity: Issued: 01/02/2001 Parcel Nunmber: 41206114 Applicant: JUREKOVIC, JIM ISSUED BY: Address: Phone: 714-540-4517 Zip: Owner ROBERTS, WILLIAM P TR Address 1071 SAN PABLO CIR Phone: COSTA MESA,CA Zip: 92626 Contractor: JUREKOVIC BLDG. CO. Address: 120 BROOKLINE LANE Phone: 714-540-5417 COSTA MESA, CA Zip: 92626 License: 548410 SCOPE OF PERMIT LEGALIZE MISC.CONDUIT INSTALLATION FOR RELOCATION OF ELECTRIC COOKTOP.NO OTHER WORK ASSOCIATED WITH THIS PERMIT. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $18.20 1 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to lhp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $41.70 • Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for tho performance of the work for which this permit Is Issued. Mworkers'compensation Insurance carrier and policy number are: Card Policy Number: section need not be completed if the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for whi his permit Is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation I: -of California,and agree that If�ould become subject to the workers'compensation provisions of Sect' n 3700 f the Labor Code,I shall forthwith comply with thus'- -. .Applicanu6ignature: / .-' Date: I v WARNING:FAILURE TO SE a'RE WY- ERS'COMP 4• COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTI S AND CML FINES UP TOONE HUNDRED THOUSAND DOLIARE(5100,:r r),IN ••DRION TO THE OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. We LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chap a 1(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.M Class a / ' (Contractor's5 gnalure:a_ s��I�i �I A •• ` Date: ,L_IL1��'1—l^L/' CONSTRUCTION LENDIN�NCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Ls 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.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,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document.i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safely Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes ❑Na (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one lime has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). o...pe__._._. __.__p.._ _ .__ 3 Does es will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention—Program for acutely hazardous materials)? No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 II an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No _.-- 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (if'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (if'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection p poses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ignat. OI ege�t/lOwner(s) c- zed"Ap nptka CODE I P OH TYPE DATE 181111AL$ CODE If INSPECTION TYPE PATE ItTIDALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical /—/6-01 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 7_ 6 = Applicant to fill in all spaces except those within heavy border lines.and sign all appropriate declarations. CITY OF-COSTA MESA .CONSTRUCTION PERMIT� 7� 1 PERMIT NO. TRACT¢NO. LOT NO. UNIT NO. A P # C( � 'Z - D� � 14^ Zane K � Project Address 0� SCN 4a131-€0 aW`i.�c 13 3 t9 Z� I �� ✓8 ( 3 S Main Building: Accessory Building: Applicants Ma7d\i ng��jAydd�re/sps� }z TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION ❑ REPAIR . • jK+-��' `ss t •- -r 17 Phone�2J.1_5 8 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER j T Front Q- •-�-�j A 0 Owner:Is-Name t Ram) /� h /'' DESCRIPTION OF WORK/USE OF BLDG. A ,Rear / N Address k/vy�t‘'u,_a.�t-San Ra �U ) i "�5'FL� Lin Q. 1 ze'j \ - I Arch/Eng.I nIthad On-on License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL C Right o� - c-tyn (of ( IRK-- a_ G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICzAL ' S - Left t5 R Contractor's Name Phone ❑ OTHER t`Q.iVl47i3 Ping. Ref. # Parking Req./Provided E PROJECT DESCRIPTION SQ. FT.ZZ&NEW'' OCCUPA Yp�� p �j�; Cl Address(mailing) ( \) vq Planning Notes: (ltd d de,W/)bdl rn '4-cs' M �/\ C ON ST RUCTION TYPE I1J VALUATION$ Yl — p�� '11- _/ �)� • s City License No. - ZONE GRADING CU.YDS. ACRES �-�A-. 'e-401.5- kk.-- vc&f c_ - 4 T LICENSED CONTRACTOR DECLARATION /� q �/' .,(n, ` 1 Up 1- S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: P C. r s (1- 11 / p_r �n is 1 o ` 7 H�I &le et o'reY C,�+Ib-t1)� 6A-1-11i Lr with section 7000) of Division 3 of the Business and Professions Code, and [ {{ r{\(J�„ Y•fG7 ` L U my license is in full force and effect. �y/ /� `� ELECTRICAL FEES License Class License No. P'c aY v a7—8-8 s nate Signature PLUMBING ( FEES Automatic Washer Transformer ❑ 15-50 KW • ORKERS'COMPENSATIONnder provisi •Sink Showers Construction Pole Sub. 0 50+KW : hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section • Cooking Unit Meter Dap to 100 amps 3800, Lab. C.) Backflow Preventer Service Sink r - - - - Policy No. Company Backflow Irrigation Sewer-Cap • .. i - Dishwasher Meter Dover 100 amps 8 Certified copy is hereby turn isnetl. - - Dryers OGas ❑Electr Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection \\ Date Applicant Fan EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Motors ❑0-1 HP ❑1'N,,=8 (Tleshis section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.D. Inc.Solar 09-15 HP ❑16-15+ - - 1 certify that in the performance of the work for which this permit is issued, - - Fi%tures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank ,i • i r Microwave Workers' C n e n La s of Califgtaipe m q L , Date ignat tire /t%•t-r^'d'CU-a'V Floor Drains Swimming Pool w/Spa' J• • Device Boxes Pole Light NOTICE:I ,after--� this declaration. you should become subject to the Outlets - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . Urinal Range ._ comply with' such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water Closet $witches Sign I hereby affirm that there is a construction lending agency for the performance Garbo g-¢Disposal of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater p Standing Sections Lender's Name Lender's Address - Kitchen Sink ' Water Service Generator ❑0-5 KW 05-15 KW ti Trash Compactor OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash 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 - 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 - Reinspection Fee $15 ' Issue Fee $ 3 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 DEVELOPMENT SERVICES REQUIREMfrNTS: .LI I, as owner of the property or my employees with wages as their sole 'Reinspection Fee I $15 Issue Fee - $ ' jf Q5 profferedcompensation, will do the work,and the structure is not intended oofferetl Zoning Approved By Date �� ' �`� for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES ' Building Approved By Date License Law does not apply to an owner of a property who builds or improves a - - Q -Uyp thereon, and who'does such work himself/herself or through his or her own Application Issued By 7r�•-} Date'1-10 6 employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I. 0 sale. If, however,the building or improvement is sold within one year of com- Canopy Type II 0 pletion, the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground _ SUMMARY OF EES p f*the.purpose of sale). BUILDING PERMIT $ 2Z•S°2? SMIP $ 1 LLa II, a�,lowner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System tractors tp construct the project (Section 7044,Business and Professions Code: PLAN CHECK $ PERMIT The Co actor's License Law does not apply to an owner of property who Duct-Ventilating ❑o-100,000 BTU 0100,000 BTU . PLUMBING $ ISSUANCE $ build:- mproves thereon, and who contracts for such oroiects with a con- • - tractor(s) 'cense pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ 0 Tam exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG 44 Fire Dampers /�� PLAN CHECK 50% $ MICROFILM $ Date LAIS-(/k/owner nadeek ✓�-+ r--s^^e-C/�-/ l Heating System& Ducting - Registers MECHANICAL $ / I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL TOTAL FEE $ 22_20 Information is correct. I agree to comply with all city and county ordinances ` PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- - sentatives of this city�to/enter •on the above-mentio ed pr per y for inspection pur s (1..� •f I Signature ate /� Drivers' License or SS Reinspection Fee $15 Issue Fee $ 3 _ 0865-46,rev. 5/8B White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 E: 11/t8/SS TIME: 09T:41 . _ -r. �f1T�. �1�1�/�fSFi r��:4i ' CONSTRUCTION AND PLANNING Pt,-IL &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 - 5.1 Steel Reinforcement ; / 56. Rough Plumbing & Pressure Test 6: Electrical UFER Grnd: 1401 57. APPROVAL TO COVER-GUNITE 7: Footings '_ `/ 58. Electrical Conduit-Undrgrnd. _ 8. Foundation / 59. Gas Pipe, 0 Undrgrnd., Test i 9: Water Pipe-Undrgrnd. !!! 60. Backwash Lines, P-Trap, 0 Undrgrnd. '; 1 . • . • • 10.iStructural Floor System61. 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 1,6. Rough Electric Wiring 67. Fencing & Access Approval 0. 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 &Nest 72. Underground Flush 24. Roof Framing •+ • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing • . /Olgd 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monbcoat 75. Dry Chemical . 27. Frame and Flashing I Q4/f, te 49 76. Dry Standpipe 28. .Lathing & Siding y/ 9 AV 77. FIXED SYSTEM FINAL 29. Insulation / 7 aQ _Art � 78. FIRE PREV. FINAL 30. Drywall Nailing . 7 4yHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat / J/'q de:::=7 79. FINAL INSPECTION 32. Electrical Power Meter-Final" /' 80. FOOD CERTIFICATE ISSUED 33. Final Electric r, .S/A-9 / Notes: 6 a 4, / -/T�ly 34. Final Heating & Air Conditioning c.• 35. Final Gas Pipe-Test 36. Hood or Canopy ��IC� (KLK�!d�j 37. Final Factory Fireplace //// 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final • 41. Solar Domestic-Final 42. Backflow Preventer -r 43. Backflow Irrigation 44. Landscape IrrigationSystem ' 45. Sound Attenuation - 46: Handicap'Regulations • / //// a 47. FINAL STRUCTURE & BUILDING 2///07 clep:.. ' 48. Special Requirements Completed !!! f �'�� ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No, Date - CERTIFICATE OF COMPLIANCE g0(o v PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT Developer/Applicant : (11r 1-mr5 • W n . !F'• ROterlm Address : 1011 f)C -n Poi()to cur do Qos I V a Telephone Number : 114 5b7 -cja.,S-7—' Tract/Parcel and Lot Number(s) : Pn ^ r ab Location of Project : 10—H ,SCLYI lo Ct_r Number of Square Feet of I Residential Space 37 I x $1 . 50 Total 5` 6. J b Number of Square Feet of Commercial and Industrial Space x $0 . 25 Total - Commercial/Industrial Project is : (Check One) Mini-storage Motel Preschool Movie Theater Bank Auto Repair Racquet/Health Neighborhood Shops Hospital Warehouses R & D Large Office Heavy Industrial Hotel Office Bldg . Regional Shops Medical Office _ Restaurant Light Industrial Office Park Fast Food The provisions of Government Code Section 53080 are not applicable . This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . Checks are to be made payable to Newport- sa Unified School District . Businessaanager Newport-Mesa Unified School District The above representation as to square footage is true . Developer/ Applicant agrees that if it is later determined that such representa- tions are not true then this certificate shall automatically terminate and the appropriate City/County shall be notified . Date : i t ' /s 188 ( CT-kc k1 \ke—LQiL.7JJ Developer/Applicant ////059 `Debora-h Rahe��t,S C"`'Y OF COSTA MESA - CALIFORNIA 92628-1200 P.O.BOX 1200 Insulation Certificate %O '7/ ti� n-) ',W//o en",-/7 ge-Y4 /7i/XV/¢ / & — Nwnber and Street City �� /3 County Subdivision Lot Number Description of Installation ROOF Material /f i Oc le Brand Name 7./ec Thickness(inches) 340.7 4�1.: prAur --. . J Thermal Resistance(R-Value) EXTERIOR WALL Material .Z6&ZCa i 1 Brand Name -G2e.J 9 aes-CA)./AJ Thickness(inches) 3 /7 Thermal Resistance(R-Value) ,-// CEILING , sititn c Batt or Blanket Tyi Zla f /dda Brand Name Oto' c 7 C2T Ni•—'c Thickness(inches) _ Thermal Resistance(R-Value) 0.0--/55 Loose Fill Type Brand Name Contractor's minimum installed weight/ft! lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material £; a r&' Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) FOUNDATION WALL Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Tide 24 of the California A strattve Code. ontractor(Builder) License Number � s"'�rt 0-1---e)4-9-1 . / ' 2 -97 Signature and Title Date Sub-Contractor(Insulation` Installer) License Number L�itTB-�k- Signature and Title Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - PERMIT NO. TRACT NO. LOT NO. UNIT NO. ._TY OF COSTA MESA/sCONSTRUCTIOJNJ�P�E[RI�II�IT gist.. i F 3 7�9 A.P.# _ zone Project Address /v #7 /(i' Sohn) m9—",co Mgist.. - r 1��fff��(((((( S Main Building: Accessory Building: Applicant's Mailing Address / �P0et beet• )1C, , . )zg TYPE OF CONSTRUCTION ❑ NEW ADD LI ALTERATION L I REPAIR ❑ CONVERSION ❑ DEMOLISH OTHER T Front Q Owner's Nym4 : - i L _ Phone- DESCRIPTION OF WORK/USE OF BLDG. I B Rear N Address X07 / p9Abl r - ' CZ- , dzils-6FI111S� A I Arch/Eng. License No. TYPE OF PERMIT ElGRADING ElFOUNDATION ElSTRUCTURAL C Right N Address ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL I $ , Left R Contractor's Name per — Phon J� ❑ 'OTHER Ping. Ref.# Parking Req./Provided E Address(mailing) i10/ a-tC,t ;D t- c74 /y >/-.atl PROJECT DESCRIPTION SQ. FT...' OCCUPANCY A-3 Planning Notes: _ M CONST RUCTION TYPE V. ACRES T City License No. �`U ZONE _ GRADING CU.YDS- ACRES LICENSED CONTRACTOR DECLARATION S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: .r7 ��/ with section 7000) of Division 3 of the Business and Professions Code, and I� my license is in full rce and ffect. �(]� J - ELECTRICAL FEES License Class a�e��ri (e g1rD z�d�7 / 0 Late/2^ Signature C'�g'.,, PLUMBING FEES Automatic Washer Transformer ❑ 0 KW 50 5 KW 1 KERS'COMPENSATION DECL RATION . Bar Sink Showers Construction Pole Sub. :eby affirm that I have a certificate of consent to self-insure or a certificate copy or Workers' Compensation Insurance, or a certified thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 3800, Lab. c.) Dishwasher Meter Clover 100 amps Policy rvo. Company Backflow Irrigation Sewer Cap _ BCertified copy is hereby furnished. - Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant , Fan Motors❑0-1 HP ❑1%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors _ (This section need not be completed If the permit is for one hundred ($100)or F.A.U. Inc.$Olay ❑9-15 HP ❑16-15+ less). ' Dishwasher Solar Piping I certify that in the performance of the work for which this permit is issued, I - ,/1, FlxtUre$ shall not employ any person in any manner so t ubject to the Drinking Fountains Solar Tank • 7 Liwt"-) Microwave •3 O c Worker Com n Ion Laws of Californi / // Device Boxes Pole Light Date �Z—/ Signature I , Floor Drains Swimming Pool w/Spa 9 NOTICE: If,aftertirgaking this declaratio , you should become subject to the / Outlets Range .-.Yl Workers' Compensation provisions of the Labor Code, you must forthwith ' Floor Sinks Urinal f0 7t/ comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Ater Closet Switches Sign Z 74 I hereby affirm that there is a construction lending agency for the performance of the work for which thispermit is ed ($ectiop 3097 Civ. C.) interceptors Water Hater Garbage Disposal Standing Sections Lender's Name ��+ «' .Lldrd Lender's Address Kitchen Sink Water Service - Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash 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 • any structure, prior to its issuance, also requires the applicant for such permit 'o file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains e Contractor's License Law(Chapter 9 (commencing with Section 7000) of ,vision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $I d0 .nerefrom 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). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: LII, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee • Zoning Approved By Date compensation, will do the work, and the structure is not intended or offered _ for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By ^ • Date / License Law does not apply to an owner of a property who builds or improves __ -_..- -. - ._ _ _ y< �.�/�` ��Q thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ Application Issued By ,�`*�W Date ! O employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of con- Canopy Type II 0 SUM Y OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground prove for the purpose of sale). - BUILDING PERMIT $ SMIP $ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project(Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100 000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- ENERGY P.C. $ tractor(:) license pursuant to the Contractor's License Law). 1 am aware that Exhaust System El Multiple ❑ Sy m Repair/Alteration PLAN CHECK 25% $ , proof of their Worker's Compensation insurance should be provided to me. - ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ELECTRICAL $ Z1-Z5-- GRADING $ PLAN CHECK 50% $ MICROFILM" $ Date Owner Heating System& Ducting Registers MECHANICAL $ Z 2 I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL TOTAL FEE $ J information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to buil construction,and hereby authorize repre- sentatives of this it er upon the above-mentioned property Inspection purpo Date /` /� oU Signature Reinspection Fee $15 Issue Fee $ 3 01 00022747-00022747 TOT 29.x` Drivers' Licen r SS yf, - DATE: 12/16/SS TI11E: 11:23 0865-46,rev. 5/88 white - Building; Canary - Applicant: Pink - Accounting; Goldenrod - Assessor y CONSTRUCTION AND PLANNING Pt &SPA Date inspector - Date Inspector APPROVALS Permit# APPROVALS Permit# 1. Temparary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. ,Electr.ical Conduit Utility-Undrgrrid. - 54. Forms .{ • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcem4nt - 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 6. Electrical UFER Grnd. iI 7. Footings . 4, 58. Electrical Conduit-Undrgrnd. 8. Foundation i 59. Gas Pipe, 0 Undrgrnd.,Test ' 9..Water Pipe-Undrgrnd. ', 60. Backwash Lines,P-Trap, 0 Undrgrnd. . .i 10yStructural Floor System - '" • 61. APPROVAL TO DECK 11. Prdperfy,Sewer Line"& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap ' : - • r 63. Heater & Vent-Final 13..•Roof Drains 64. Plumbing System - Final 1.4. Rough Plumbing 65. Electrical-Final . 15. Rough Electrical-Conduit 66. Solar System-Final 1.6. Rough Electric Wiring /'19.8' g 67. Fencing & Access Approval 17,. Rough Wiring Sign • . ., , . 68. APPROVED FOR PLASTERING I.18. Rough Electrical-T Bar Ceiling - • -_ 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace _-I APPROVALS Permit# 2t. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating e1 . 71. Product Piping 0 Gas ❑Oil, . • . 23. Gas Pipe-Rough &Tett 72. Underground Flush 24. Roof Framing -• j.- 73. Unde• rgrnd.Storage Tank 0 Gas ❑Oil - `e , Rbof Sheathing . , , . • 25 74. Overhead Hydro r 26. T-Bar Ceiling (Structural) &.Monocoat _ - 75. Dry,Chemical r • 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 33. Final Electric Z--/ Notes:� //2-/c�_g nee/ lad L1p,/�„/Q,/ions 34. Final Heating & Air Conditioning . �(L1C�'_�_q` Ofe 35. Final Gas Pipe-Test / 36. Hood or Canopy 37. Final Factory Fireplace • t 38. Final Plumbing , , 39. Water Service-Final , 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation ' , I 'r 44. Landscape Irrigation System I , 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 . r' 51. CERTIFICATE OF OCCUPANCY • - No. Date ! ' . OWNER HELTZER ENTERPRISES-C. M. DATE 9-26-69 JOB ADDRESS 1071 San Pablo Circle BUILDING PERMIT NO. 30868 GENERAL CONTRACTOR Same DESCRIPTION of WORK Residence Si/Attached Garage AP No. - LOT 13 TRACT 6638 FIRE ZONE VALUE $ 22,034,00 INSPECTIONS Si n .1 R atuja Date GROUP I & TYPE V ZONE -1 ISOI NS / -54-7-W.-715 SUBCONTRACTOR PERMITS ISS ED GAS Date Number Signature WATER LA9 ftir1r-57_7a P mbin! ROUGH PLUMBING J /ys 27.-7�i' / // i2•'7 oi(7/ PROP. SWR. LINE ?HOUSE CON. •ft,( <,-A,-70 ✓/ R , .5!O` 6' SPRINKLING SYSTEM $ 7c lc�/ MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING h.1 St-71,4-20 TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING r (y-9-]o ` Hea be Ve f TRENCHES FORMS STEEL REINF. r�� X 9 `r-Y .r[/,{ if .�! /A 7,3 FLOOR SYSTEM d Y-rn-TO !Y!7 rUitt kr./G'S .).Z 7n 7/3 BOND BEAM n STEEL REINFORCE n / Y, SHEATHING 11. 6///ING -FRAME AND FLASHING 6-Ar-rre LATHIN OUT IA L`C rye PLASTER, BROWN COAT ?moo STRUCTURAL, FINAL / .�5 t Ele I HEATING, VENT., REFRIG. AND / Z5' by —Age.-- j iti, 6-3-7,0 2 1189 PLUMBING, FINAL AND GAS TEST n Ji,, 5'a-2 7U ELECTRIC, FINAL AI /. 7 BUILDING, FINAL Ilsd Za"'(A 30868 'HN 12-69cfsa00 400* ***1211.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECEIDAy DATE RECE VED DATE ISSUED BUILDING 1071 San Pablo Circle KK///L��/f�i lj/E �y SEP 2 6 1969 OWNER Heltzer Enterprises-Costa Mesa A.P. NO. •.21-)0100 MAIL BUILDINGDRS /0 !/ D c& ADDRESS 740 No. La Brea Ave. II ADDRESS .VA ,/ �r,�„� W CITY L.A.Calif. NOL'9 732171 TRACT 6638 LOT 13 BLOCK I- Z ZQ CONSTRUCTION United California Bank NEW J ADD I ALTER (REPAIR (MOVING DEMO(ISH ON LENDER (//I a co Main Office . J D BRANCH mJ ADDRESS 6th and Spring OWNER VALUE ,� /� ' -I•CO ARCHITECT Q OR ENGINEER Frank Gonzales NOL' S32n687E USE �� $197,2 ✓�'� N / n La= ADDRESS 1336 E. Chapman Ave. ,Orange,CaL ZONE TYPE i GROUP 0_1.9 APPROVED WO CONTRACTOR George J. Heltzer & Assocs. BY DATE 61 Z same as above J IL ADDRESS uJ w TEL. ZONE NO.OF USE OF NEW Single Tarn. Zl- CITY NO. Rl PLANS 2 BUILDING Res. w/att.Ger. w0 STATE 201098 CITY 1707 YARDS APPROVED YARDS APPROVED N IL LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING DO (FROM C/L STREET) SIZE I NO.OF BLDGS. +� OF LOT NOW ON LOT FRONT COPT.FT. FT. USE OP EXISTING BLDG. R.SIDF ' ? FT. FT. H SIZE OF NO.OF ZZ NEW BLDG. ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALL ROOF U A^ .4, COVERING COVERING REAR `D FT. FT. -I USE,OP BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& C. C. MAIN BLDGS. ACCESS.BLDGS. O Residence with attached Garage VAR.* _APPROVED / H Plan 402- fc7 ABY ROVEDIS 11t1.D , DATE /3/r 6 /V y Z 04// 0 t~.1 I hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with Crall laws regulating building construction, and I shall not employ �� y26 I- any person in violation of the workman's compensation laws of ��/�� r//�� , Z the State of California. s� Y 0 ? I hereby certify that I am properly licensed as a contractor under / SO. FT. V �� 0 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ;/�U Chapter 9, and that such licenses ere In full force and effect,or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 3 am exempt from the provisions of the State of California Business sitVALUATION [c and Professions Code D ision 3,Chapter 9. 0� Q o PERMIT FEE $ +' `�' w Signature ofe.-F //7.,O Permittee $ j / (j� PLAN CHECK $ 7, / '.-sT�. g,.J- /7d ct TOTAL FEE $ "4` / '— LL Authorized Agent COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT I I + RECEIVED BY DATE RECEIVED-DATE ISSUED BUILDING /a 7 i �!AAJ (4-4-114 - Armor ADDRESS 1 �//�✓r PERMIT NO. OWNER A.P. NO. MAIL BUILDING ADDRESS Z ADDRESS U CITY NO. (nlnJh TEL C- TRACT LOT )3 BLOCK Z Z Z < CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI EH O N LENDER tL m J 0 BRANCH ' - V) OWNER m_I ADDRESS VALUE -CO ARCHITECT TEL. i USE $ Q OR ENGINEER NO. V Q FIRE w CC ADDRESS ZONE TYPE GROUP aW W Z APPROVED J O CONTRACTOR BY DATE CO Z J K ADDRESS W W TEL. ZONE NO.OF USE OF NEW O= CITY NO. PLANS BUILDING ZI W STATE CITY YARDS APPROVED YARDS APPROVED N¢ LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZE NO.OF BLOCS. OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SAIF ET. FT. I— SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L SIDE ( �(xI? FT, FT. VEXTERIOR WALL ROOF q' _ COVERING COVERING - REAR D1J FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& D_ o_ MAIN BLOCS. ACCESS.BLOCS. Q VAR.#k DATE O /n/� C.U.P.# Q// /A/�� APPROVED ,^ // n ) Z v (.JQ7 APPROVED ( CV 0 _ DATF if? i// v 0 G UI hereby acknowledge that I have read this application and state D that the above Information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of GO the State of California. W ZI hereby certify that I am properly licensed as a contractor under SQ. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the Stets of California Business CC VALUATION end Prof erosions Code,Division 3,Chapter 9. co PERMIT FEE $ Signature of m Permittee $ PLAN CHECK $ E `o u. Authorized Agent TOTAL FEE $ CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO 6638 DATE December 1, 1970 LOT NO, 13 ADDRESS 1071 San Pablo Circle, Costa Mesa 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) Kenneth E. Richter(rys-or-were) Dorothy J. Richter 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. BY 4/ Purchaser�orothy J. Richter BY Developer n or authorized representative BY Lender BUILDING SAFETY DEPT DEC 16 1970