HomeMy WebLinkAbout1053 SANTA CRUZ CIR - Building Permits ' 6.14- • CITY OF COSTA MESA
fro, BUILDING DIVISION
>'`l . , DEVELOPMENSSERVICES DEPARTMENT PERMIT NUMBER
1‘4.
unilinn 1
1 -
04111—
. PERMIT J1302-01600
4Cbibroamo ei'o
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
BUILDINGJob Address: 1053 SANTA CRUZ CI Status: ISSUED
Suite: Applied: 10/02/2002
Vicinity: Issued: 10/02/2002
Parcel Number: 41206133 Zoning: R1 R1
Applicant: FERGUSON, LEW ISSUED BY:
Address:
Phone: 714-630-5543
Zip:
Owner DRIVER, TEX W TR
Address 105 ASH CREEK COURT
Phone:
FOLSOM,CA Zip: 95630
Contractor: MC CORMACK ROOFING
Address: 4091 E LA PALMA
SUITE D Phone: (714)630-5543
ANAHEIM,CA
Zip: 92807 License: 643700
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING, INSTALL SHEATHING AND FELT,APPLY 30 YEAR COMP SHINGLES. FLAT PORTION NOT INCLUDED.
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $2,000.00
Permit: $69.25 Claim Valuation: $2,000.00
SMIP Res: . $0.50 •
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $69.75
• PLANNING &ZONING
SETBACKS -
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 ' Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§ 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754.5626
2446-46(6/00)
DECLARATIONS I f, 1 �•Th
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensatio: as provided for by section 3700 of the Labor Code,for the performance of the
wfor which this permit is issued.
I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued.
My workers'compenn tion Insurance carrier and policy nu er are:
Carrier: �O'( d£$I0-.? 5 Policy Number: 1.,C- F4 7 5 o-o °t7 0
(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 which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califor ' and agree that if I should become subject to the workers'compensation provisions of Secti n 3700 of the Labor Code,I shall forthwith
comply with these provisio D et
Applicant Signature: /L.- Date: I 0 �i C)
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION VEvE ISUNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P NAL S AND CIVIL RNES UP TO ONE HUNDRED
THOUSAND DOLLARE(3100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.# (243 Cr0 Class is C 39)3
Contractor's Signature: ��- • 5 ....per^-- Date: I v-1 u 2--
CONSTRUCTION
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).
Lenders 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($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 driver's license. 0 Yes ❑No Driver's 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 Safety 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? ❑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 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 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).
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 ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes U 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 De constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑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 Califomia 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 purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
` ,c- re Of Legal ( / • �9
An Or Aulh ed Applicant Date
CODE t IPSPFCTION TYPE HATE INTRIALS CODE I INSPECTION TYPE PATE !KOALA
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final (� g9 208 Final Plumbing
200 Final Re-Roof 19—P (—OCA 210 Final Electrical
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
ADDRESSOFBULODC: 1053 SANTA CRUZ CI 01R' CITY OF COSTA MESA - BUILDING PERMIT
tMNERSNAMEIPIWON'N: DRIVER TEX W TR FLOOD: AH-38 PERM NO: B 081245
ADDRESS 1030 DAMASCUS
MESA,CA 92629 PERMIT NO: B 081245 PLAN CHECK NO: N GOVT: N SUPP: N
842-3622
AWL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: 0TH
ARCHITECT OR B4dNFEA: sac No.: JOB DESCRIPTION : T/OOF 6 REROOF W/BUILT-UP SQ FT: 2, 100
ARCH.0R DIG'S ADDRESS:
WIT:
CLAIM VALUE: 2, 100 . 00 CALC-VALUE: 2, 100 .00 GROUP OCC: R-3 /
CIXRRACTOWSNAME: ACTION FIRST ROOFING SERV ( 714 ) 842-9122
CalTRACTOR'S MNUNG 7472 SLATER AV COMMENTS: REROOF RESIDENCE W/BUILT-UP
ADDRESS: HUNTINGTING BEACH CA ucNo.: 688649 *****************'*+ **********************************************i4'*************
92647 ova ZONING REQUIR EMENTS
-- LICENSED CONTRACTORS DECLARATION:I hereby ern under penaly d prpry that I am licensed under provisions of Chester 9 S E T B A C K S
(Commencing with Section 7000)of Division 3 d the Business end Professions Code,and my license is in Id force and affect.
CITY LIC.NO.: harm 6430 LK.CLASS: C_39 LlC.NNOy68 649 P P: 05/97 MAIN BUILDING ACCESSORY BUILDING
Date: / / cowmar. / 3%/.�jGy`! FRNT: FT IN REAR:
IN RGHT: FT IN FRNT:
LEFT: FT IN REAR: FT IN
�/J LEFT: FT FT IN FT IN RGHT: FT IN
WNER ILDER D LARATION:I herebyd
affirm under pearly pasty that I am exempt the Cee-- Lissa law for the
' reason(Section 7031.5 DAMNS and Professions Code:My sky ce county litich reguires•Pernik 10 constlud.eller.Morose PARKING REQ: PROV: PARCEL: 41206133 ZNE: REF NO:
nofish,or repel any structure.prior to in esueice,ab0 Marine the append forsuch permit to fine a signed statement that he or she dV
a pursuant puu to the provisions the Contractors License Law(Chapter 9(commencing with Sedan 7030)d d Derision 3 the PLANNING N TES>
Business and Profession Coble/that he or she is exempt therefrom end the basis for the alleged exemption.My violation d Section ,5 .
7031.5 by any applicant for a permit sub4eda the applicant toe civil penalty d not more than It..hundred dole fS500l). *******************************************************************************
❑ I,as owner of the property or my employees with wages as thee sole compensation,will do the work,and the structure is not intended D E V E.-I. 0 P M E N T S E R V I C E S R E Q U I R E M E N- T S
or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to en owner of properly
who builds or'improves thereon,and who does such work himself or hereel or through his or her own employees,provided the such
improvements ere Ml Wended or dieted for sale.If,however,the building or improvement is sod within one year d completion,the ZONING APPROVED BY DATE: '
ownerAstdder will have the burden of proving he or she 514 not build or improve for the purpose d sale). -
O I.as owner d the properly,am exclusively contracting with licensed contractors to construct the propel(Section 7044.Business and
Professions Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon And Wer BUILDING APPROVED BY : DATE: • _
contracts for such protect*with a contractor(s)licensed pursuant to the Contractors License Law). •
�/I'�� /
/`
❑ I am exempt under Sectio,: B.A P.c.,forthis reason: APPLICATION ISSUED BY: - DATE: Il
******************************************** *********************************
Date: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby candy that I em aware of and understand the remdremasa of California Health end Safely Cod.Sections 25505.25533.and
25534,and Nat I or any Mure building occupant will/wD not(drole ane)need to camply with said stele codes and the requirements for
far permit BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 74 . 75 . 50
Dale: Apprcad: SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm elder penalty d oned peusy the following declarations: PLAN
ISSUE FEE
o Move and will mddeb ecertificate dmewl tout peri far SSued.n'compereetion,es provided fel by Section S700dtM label BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
cad..lrlhep.domre.dg»wrkf«w:chnbprdbaatr.e, TOTALS----> 75. 25 0 . 00 0 . 00 75. 25 75 . 25 . 00
0 I have and w mental.waken'compensation insurance.es required by Section 3700 of the Labor Code,for the pnfrmance el the
work for which this Permit is*ued.My workers'compensation insurance carrier and poky number are:
Can*: NArp UNION FIRE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 75 , 25 OVER/SHORT: . 00
Policy Number 00-50 /R4'4 09/01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed the permit is*one hundred dollars(Sloe)Or kw) 74 . 75 . 50
o I eerily that in the perfrmer e d the work for which this permit is issued,I shall not employ any person in any manner•o as to
beton su to the wader'compensation laws d California and agree that 1 I should become subject to the workers' *******************************************************************************
compenea rev d Section 3700 d the Labor Code,I shall ton with odnply with t . .provisions. I N D I V I D U A L F E E B R E A K D 0 W N
y Dela: i � '7-2 App bad
Wannm Filureto @cureworkr:ro°wne•doncoverage faunlawful,and shall sub. • ' •foyer tocriminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
de new w to on.hundred thousand dollars(1100,000),In addition to the cwt of.. tan damages as provided for In
Section 3706 of the Labor coo,Interest,end adomayl fess. SFR 2100 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 100 . 00
• CONSTRUCTION LENDING AGENCY: I hereby alfimn under penalty of perjury that there is a construction lending agency for the END OF FEES
performance of the work for which this perms is issued(Section 3097,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
1 certify that I has read this appliation and state that the above information is coned.I agree to comply with all coy end county ordinances
and state lass rNukig to Mddng construction and hereby authorize tepresrnahees of this cey to enter upon the above-mentioned property
Ir elm rapOees. I 1
�`���J-13 Ph �f vT?i 81-21-1997/11:43 AM/$75.25
//� � ), 7 PERMITRC:081245
•
Dee:
Signature d, . AppiwdrCrdrrer
•
(5151.46.WP) Whit- :ii.' •A Safety:Green-He Canary-Applicant Pink-Revenue:Goldenrod-Assessor
1111.111111.r- •
CONSTRUCTION AND PLANNING PC & 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
.:11'Eleetrical Gondola Uiility-Unctrgrnd. 54. Forms
_. -Electrical Condiiit�,l7Tdrgrnd. . ' 55. Electrical Bonding iI
35.:SlWeel Reinforcertient- - 56. Rough Plumbing & Pressure Test
'r-,CC:,Eleitrical UFE R:.Gin�. 57. APPROVAL TO COVER-GUNITE-
•4: F
Footings .-. 58. Electrical Con"rUndrgrnd.
1?8."Roundation .. a:_`,_ -- 59. Gas Pipe, 0 Undrgrnd.,Test
;9. Water Pipe-Undr`grnd'- - 60. Backwash Lines;P:Trap, 0 Undrgrnd.
10. Structural Floor-Systet71 61. APPROVAL TO DECK
•
11. Property Sewer'Line & Houso_:Connection 62. Backwash & Receptor-Final
12. Sewer Cap < 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final
T4. Rough Plumbing- _ 65. Electrical-Final
15. Rough Electrical'-Conduit 66. Solar System-Final .
16. Rough Electric Wiring 67. Fencing & Acceas`Approval
17. Rough Wiring Sign -- ti'
68. APPROVED FOR-PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. rRough Factory Fireplace - - - - - _ -:APPROVALS_ : Permit # -1 -
•.. r'- - > c rr o - _. - r- •
21. Oucfs,in-Struttur ; _ - r `• .; r _' 70. Underg"ioynd Hydro - '
22. DUCE, Ventilating-x -,
-• . _ r r 71. Product Pipingfl9as ID Oil
23. Gas P1 pe Roujl1 &T€st .-�. . . _ c. G' F• 72. Underground Hush, K .`
24. ,RoofFraming. - i...- `•-r- r� : r`r-• •.-. r71 Undergrnd.Storacje Tank 0 Gas O"Oil
25. Root Sh@ething v�6)1 �. a'* 74'. Overhead Hyclrn✓F"r' .r
26. 3-BaryCeiling (Structural) & Mo_nocoat t J n - 75' Dry Chemical - -4 - C
27. Frame and Flashing * _ 76' Dry Standpipe _ _ -
_ 28. Lathing&Siding i..• •. .. �. T - .
g 7-< '�C= „t 7731 FIXED9YSTEM-FINAL r
29. Insulation �:�. C '<. ' , 78, FIRE PREY. FINAL ,; r
30. Drywall Nailiog _ r - w --HEALTH DEPT-REQUIREMENT
H 31. Plaster BCawn_Coat.'r ._ „ t _ 79: FINAL INSPECTION '
Ci
32.-ElectricaFPoveer Meter_Final �` r r; 't 807 FOOD CERTIFleATE ISSUED
, _ 33.'ZinaTElectric
f 't Noes: :,;. $ __ 0 _
.
34. F,inaFHeating-& Air Londitionirt5-7 .: o _,
35..Final^Gas-Pip9-Test .: I * _ i' tr.S • SK
36. -Hood.orlanopy . _ - = a x r. s �, r
' 37. FinarFaetory Fireplace c `' -. * '� ; I `` = u`^
38. Fina' Plumbing - y _ - r r
39. Water Service-Final - r• --n• * L ,_
40. Gas Service-Final _ -/: ti -
r
.. 41. Solar Domesttt-Final _i :- -x _ r _
42.'Backflow Preventer _. n• Y` -
43. Backflow Irrigation' - i.t- _
,A4. Landscape Irrigation System,-c - > -- - _ - ..)
.t_ _ _
'45. Sound Attenuation - - `•1 i- - ` I - •
_
• . .. a ^,: '- --< --
•
46. Handicap Regulation`s ? /' 4/ I "./ - -
47..f.INAL STRUCTURE & BUILDING //i7 7 / •;r tr�'
48.:FINAL PLANNING ! `- ,
-
49. Electric Release to Edison ..•
50. Gas Release to Soutern California Gas Co _ ` :<
'51. CERTIFICATE OF OCCUPANCY-- - _ - • -
No Date
OWNER SELTZER ENTERPRISES - COSTA MESA DATE 9-26-69
JOB ADDRESS 1163 Santa Crum Cirrle BUILDING PERMIT NO. 30887
GENERAL CONTRACTOR Same DESCRIPTION of WORK Residence W/Attached Garage
AP No. - LOT 32 TRACT 6638 FIRE ZONE . VALUE $22,034.00
INSPECTIONS Signature Date GROUP I & J TYPE V ZONE R-1
SOIL 44541 '13—ib PERMITS ISSUED
GAS SUBCONTRACTOR
Date Number Signature
WATER GO 4 %51/--J31J / PIu bin9 c
ROUGH PLUMBING-�'/ #44 %,
G-e 2--70 �� 3/207 O (z7/ s
PROP. SWR. LINE [✓HOUSE CON. /_ _ a G 12-70 7v4 • (_�CF7h Cd a- s.7
SPRINKLING SYSTEM /
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING ,44154 T-2c3
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER III
ROUGH WIRING n `[•�ZZ.7e. r Heating an Vent
TRENCHES A FORMS STEEL REINF. ri np. Y-i-70' /(�.l�j�yzzex , 'J 'aQ .r79-7o 7,--/-
FLOOR
,-t —/ -
FLOORSYSTEM QQa.tp- 4-/f-70 fly/.jfLhll2IVA/PeRi'fn0- $2R'� 7 .` 7,
BOND BEAM n STEEL REINFORCE n / / I
SHEATHING GA../7o
FRAME AND FLASHING
GA3 g
LATHING - IN OUT 4p,P,ee 4,011
PLASTER, BROWN COAT W 7814f C _
STRUCTURAL, FINAL ti4-7141
HEATING, VENT., REFRIG. AND A.C., FINAL F a ic/ 4,'/h�n0426l_PLUMBING, FINAL AND GAS TEST Z' L 4ELECTRIC, FINAL -.S'.70
BUILDING, FINAL ,pG', 271_3d-7
30887Pa16
!!7V 12-6900 424* ***124.50
LAID
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
• APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely REO, 7RE,r1 §VE2114§g9
BUILDING 1053 Santa Cruz CircleADDRESS
PERMIT
110
OWNER Meltzer Enterprises-Costa Mesa A.P. NO. T------ ''�0 11�5`�177�
MAIL 740 No. La Brea Ave . BUILDING ADDRESS U ✓ «v7�1•C/�L.
ADDRESS
Lau;
d U CITY L.A. Cal• TEL NO. 37=2171 TRACT6638 LOT 32 BLOCK
F Z
Z C CONSTRUCTION United California Bank NEW •-ADD ALTER REPAIR MOVING DFMOI LSH
O N LENDER Y/
a m Main Office
J D BRANCH
mJ ADDRESS 6th and Spring, L.A. OWNER ��% VALVE r� ,, /
J Q OR ARCHITECT Frank Gonzales TEL 532-6878 USE � ' ' ,/ $o�°C,Ue7Y�
z a 1336 E. Chapman Ave .,Orange,Ca: • Zo E TYPE !� GROUPi�r
E
Lu ADDRESS
0. w APPROVED
J O CONTRACTOR George J. Heltzer & Assocs. By DATE
03
J 2 ADDRESS Same as above
W W TEL. ZONE NO.OF USE OF NEW Single Fan.
0=F CITY NO. R1 PLANS 2 BUILDING RPR. watt a Gar.
_
lU U STATE 201098 CITY 1707 YARDS APPROVED YARDS APPROVED
(n IL LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
D SIZE NO.OF BLOCS. (FROM C/L STREET)
OF LOT NOW ON LOT ROM FT. FT.
USE OF
EXISTING BLDG. R.SIDE 5rFT. Ty
I— SIZE OF NO.OF i / ,s�
2 NEW BLDG. ROOMS STORIES L SIOE ) 3 FT.07/ 4(
EXTERIOR WALL ROOF
U !l /
COVERING COVERING REAR �v FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
1
a MAIN BLDGS. ACCESS.BLDGS.
Q Residence with attached garage VAR.* DATE
O C.U.P.# APPROVED
( Plan No. 402 APPROVED G 10/2 I6 7
(.13141.1) DATE
2
0
oI hereby acknowledge that I have read this application and state
n that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
I— any person in violation of the workman's compensation laws of
the State of California. '7J 1I��//77 /,!�/J co
I hereby certify that I am properly licensed as a contractor under /" �� SO. FT/j �� ✓ ��� O
the State of California Business and Professions Code, Division 3, THE AMOUNTS OWN 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: 2
am exempt from the provisions of the State of California Business VALUATION �j
and Professions Code, on 3,Ch.• er 9. m
.z PERMIT FEE $ c.2P j
Signature of 'y/ m
Permittee • $�� Q� PLAN CHECK $ / //�� E
v
o
Authorized Agent TOTAL FEE $ /02
/r
OWNER °" , N•°• DATE 7 li I"
JOB ADDRESS1053 Santa Cruz Cr. BUILDING PERMIT NO. 38976
GENERAL CONTRACTOR Wilson Associates DESCRIPTION of WORK Eat 10 Cover
AP No. k12-061'33 LOT TRACT FIRE ZONE VALUES 500.00 •
INSPECTIONS Signature Date TYPE IV GROUP J ZONE R1
• SOIL PERMITS ISSUED
GAS SUBCONTRACTOR
Date Number Signature
,, WATER Plumbing
tj ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. fl
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND D POWER ❑
ROUGH WIRING Heating and Vent. •
TRENCHES ❑ FORMS 5 STEEL REINF. 5
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN n OUT
PLASTER. BROWN COAT
STRUCTURAL, FINAL Electric -
HEATING. VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST 5
ELECTRIC, FINAL
BUILDING_FINAL .• \/Q -11. 77
I' •
389 76 •
SEP 11-ThtPai.QQ 527* 5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely RE APPLICATIONEIVEFOR BUILDING PERMIT
BUILDING /053 sold,
CY42 C r- ^�/ D_QY/ DATA R$QEIVED DATE ISSUED
ADDRESS 7 J C. L/�7/7n�_ l//��/{VZF ,C41‘4/�
OWNER .A-T- Pgr4Ncl
A.P.NO.4a.-a. -�i PER
MAIL r� BUILDING
ADDRESS _ S 7� ADDRESS l os
3 St,tiiaereir2. �.
W w /' � TEL. / f�
ILO CITY C� 'Vs�/t NO. 07S-jot TRACT�LS LOT": BLOCK
Z
CONSTRUCiI NEW ADD ALTER REPAIR MOVING DFMOLLSH
Oco LENDER
j BRANCH /' '�s
J Cl) OWNER s../[//
03 J*CC cil ADDRESS I/, 4.. �//'� /1' A / VA E l
'� Q OR ENGINEER.m ARCHITECT Skn IN '+Y�'s �l TEL. USE / �/�' $ Q
U to 1 NO, FIRE TV
/
WCC0_ 41 ADDRESS I/{� ZONE `/7 TVP ` / GRODUUPP 4/ren
it
Z CONTRACTOR I 'so �-55ec(ec}4 APPROVED �I% W DATE F e/�L•t
CO cr /( ;UD do wt dvr ''G`i( `�f
J ADDRESS TEL. ..
illu• • NO.OF USE OF NEWT/Salt,
Z1- CITY Se t. NO. 04° Z•� PLANS - BUILDING �stett-
lLO STATE CITY _K YARDS APPROVED YARDS APPROVED
co Q LIC. NO. / S Sz/G LIC. NO. MAIN BUILDING ACCESSORY BUILDING
D O (FROM C/L STREET)
SIZE 1 NO.OF SLOGS. �1
OF LOT NOW ON LOT FRONT 4-7-r-FT. FT.
USE OFt
EXISTING BLDG. 7'"/ R SIDE A4 FT FT.
I— SIZE OF NO.OF
Z NEW BLDG. ROOMS STORIES L.SIDE LS- FT. FT.
Q EXTERIOR WALLROOF .
C..1 COVE ING I COVERING REAR 3s FT FT.
J US UILDING AND WO 0 B PERF MED DISTANCE BET. BET.MAIN&
S / MAIN BLOCS. ACCESS. SLOGS.
Q r'II J I I/r//�s VAR.. DATE
Ll Id I MI C.0 P.#"• APPROVED
QitAPPROVED �r� -1!n / I C ��-f� DATE -��-2!J
Z
O / a
UI hereby acknowledge that I have read this application and state C
that the above information Is correct and agree to comply with
CCall laws regulating building construction, and I shall not employ s
I- any person in violation of the workman's compensation laws of
W the State of California. 1AX m
I hereby certify that I am properly licensed as a contractor under SO. 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: t[
am exempt from •• provisions of the State of California Business
VALUATION yam. tco
and Profession- ..:,Division 3,Ch pter 9. 0' PERMIT FEE $ �/s a—d N
Gl laO
Signature • / i•ti j/'�-. ` m
Permittee $ y / / PLAN CHECK $ �� E
Authorized Agent c/s•./`� o
s u.
TOTAL FEE $ •P'�/