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PROM 'a00RES5: 1059 SANTA CRUZ CI UNIT: -YTY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064353
D H R'sNAME: MYHILL, LOREN
ADDRESS: MYHILL, SUSIE PERMIT NO: B 064353 PLAN CHECK NO: N GOVT: N SUPP : N
1059 SANTA CRUZ CIR
COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
545-0892
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : T/O,RESHT & REROOF 2400 SF SQ FT: 4, 000
CLAIM VALUE: 4 , 000 . 00 CALC—VALUE: 4, 000 . 00 GROUP OCC: R-3 /M-1
PERMITTEE:
ADDRESS: RAY'
S ROOFING ( 714 ) 559-9369 I
14571 HIGHCREST CI COMMENTS : REROOF SLOPED SECTION W/ OMP . SHING, FLAT SIDE W/B . U.R,
IRVINE CA 92714 ********************************** ********************************************
LICENSED CONTRACTOR DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9(commencing with Section Z Q N I N G R E Q U I R E M E N T S
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect-
CITY LIC.: 019427 STATE LIC.'36104 CLASS: SETBACK S
39
/� e
Date: / n---I— 93 signature: { cJ — _ I� do MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that th.ee a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3884 Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP. DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 41206132 ZNE: REF NO:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES>
Date. Applicant: *************!E_*******************************************************.**********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E _L OP MEN T SERVICES REQUIR E M E N.-T S
I certify that in the performance of the work for which this permit is i tied.I shall not employ any person in any manner so as to become ;
subject to the workers'Compensation Laws of California. ZONING APPROVED BY
•Date: /U `� Signature: A:7 DATE:
�� NOTICE:II,alter making this declaration,you shoutd beco ublect to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : ,43
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. DATE:
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION I-SSUED B Y: � DATE: ..0 ' ' 1
which this permit is issued(Section 3097,Civ.C).
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE $MIP/RES-' GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT6 3 . 0 0
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 50.
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business T SM I P/NON R E S
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031,5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—D IV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 63 . 50 0 . 0 0 0 . 00 6 3 . 50 ' 63 . 50 1 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 63 . 50 OVER/SHORT: 00
for the purposefit sale)_ BLDG PMT PLUMBING ELECTRIC MECHANICFIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 63 . 00 , 5 0 • `-
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon Ci
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *********************************************************-**•********************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. IND IV IDUAL F E E BREAKDOWN Ti
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Dale: Owner: fi.
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE 1 ,00 r 4 , 000 , 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions. i id
Date: Applicant: �/� '"
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county S IY 1 OK E DETECTOR
ordinances and state laws relating to budding construction and hereby authorize representatives of this city to enter upon the above-mentioned , • _ ' if
.property for inspection purposes. Y
_^ Date: /v -6 -9L3 Signature: �t,11.-17.?1,-2 REQUIRED 01 00148435-00148434 TOT 63.50
•
Driver's License or Social Security a:
ApplicanC Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL & SPA •
14.„,,,.." APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector14.„,,,.."
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 j
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings - 58. Electrical Conduit-Undrgrnd.
8. Foundation _ - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
•
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
•
13. Roof Drains 64. Plumbing System - Final
14, Rough Plumbing r 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17, Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - - APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test _ 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil Eal
25. Roof Sheathing IO/(1143Nt/Fr 74. Overhead Hydro - • t
26. T-Bar Ceiling {Structural) & Monocoat • 75. Dry Chemical •
27. Frame and Flashing • 76. Dry Standpipe
28. Lathing & Siding - 77. FIXED SYSTEM FINAL • , .
29. Insulation - • . 78. FIRE PREY. FINAL
30. Drywall Nailing . HEALTH-DEPT. REQUIREMENT '"-
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical-Power Meter-Final ,80. FOOD CERTIFICATE ISSUED
33. Final Electric - Notes:
34. Final Heating$t Air Conditioning - •
35. -Final Gas Pipe-Test . •
36. Hood or Canopy _
37. Final Factory Fireplace .
38. Final Plumbing •
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final •
42. Backflow Preventer /4 "" 7-fie e Ke, .4.,00-.4.,00-�_ s' `�_ -4�
43. Backflow Irrigation ! L1/y 44.-4E-
44. Landscape Irrigation System . • -
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
p9-Lk -473 6cfr-a „et; k C-C--4�
48. FINAL PLANNING - . _ - •
49. Electric Release to Edison - - •
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
•
•
A.#
it Twithnq Laboratories of sou14et.t eaO:fo ta, enc.
P.O. BO% 47 . 3310 AIRPORT WAY . LONG BEACH. CALIF. 00801 . (213) 426-3355 . (213) 636-2386 . (7N) 928-6432
BRANCH OFFH_ES:
TEST ING 1514.0North Harper SI.... . Nen D.n•.0;..t.ni.R
Seel.Ana.Cdlioln;.0770: F ..0.So.0'
• 17/41511-las '(1414.14
3/1 `1, 1 'q Long BuaM1,C.IiI.00801 12131 686-2181,
s'I /I\
5 Yq��.4.
•
March 21, 1977
Examination: 77-1266
GUNITE
COMPRESSION TESTS ON =MORI CYLINDERS
1
Jack Hubbard
3106 Ostrom Avenue
Long Beach, California 90808
•
• PROJECT 1 SWIMMING POOL - Jim Raulstone
ADDRESS 1 1059 Santa Cruz, Costa Mesa, California
SAMPLE FROM Shallow end, deep end, bond beam
ARCHITECT I CONTRACTOR
Blue Haven Pools
ENOIY.EER SUBCONTRACTOR
Lester Paley Enterprise Gunite
SPECIFIED
MIX 3.7 sks per ton ' STRENGTH 2,000
•
DATE CAST 3/12/77 SLUMP
DATE TESTED '3/21/77 3/21/77 3/21/77
CYLINDER NO. 1 2 ' 3
COMPRESSION 9 days 9- days 9 days •
•
TOTAL LOAD, LBS. 59,000 58,000 58,000
POUNDS PER SO. !N. 2,085 2,050 2,050
•
COMPLIANCE 9 day tests comply with specifications. •
•
MADE ST DEI.IYEP.ED DT RECEIVED ON
CYLINDERS Tony Hubbard 3/14/77
DISTRIBUTION: .
Jack Hubbard - 3
Costa Mesa Building Dept.
RLL REPORTS ARE sunMITTEO AS TM[ CONFIDENTIAL PROPERTY OF CLIENTS. AUTNORISATION FOR PUSLICATION OF OUR REPORTS. CONCLUSION
TRACES FROM OR REGARDING THEM IS RESERVED PENDING. OUR WRITEEN API'R:.VAI. AM A MUTUAL PROTECTION TO CLIENTS.THE PUBLIC AND OURSELVES.
300.12 t-If — - - --
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT NO, 6638 DATE May 18, 1971
LOT NO, 31
ADDRESS 1059 Santa Cruz 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, acknoiaedges that (he-she-they)
Kenneth Dunnigan (416.0-0V-4i0-116.) Mildred Dunnigan 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 ?:.1/.4,d/id
Purchaser - Kenneth H. Dunnigan
BY
eveloper an. •r authorized
representati, e -DESOTO ESCROW CO.
BY
Lender
OWNER ROULSTONE, JAMES, & ALBERTA DATE 10-6-78
JOB ADDRESS 10 Banta Cm Cirri,' BUILDING PERMIT NO. 46844
GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Patin rover
jAP No. 1112-061 -32 LOT j1 TRACT 668 FIRE ZONE VALUE f 5O{) 00
NSPECTIONS Signature Date TYPE TT GROUP ZONEOIL SUBCONTRACTOR PEJ{MITS ISSL ED
AS Date [ZONE
Signature
/WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE n HOUSE CON. 0
SPRINKLING SYSTEM
` MISCELLANEOUS
l ROUGH HEATING AND AIR CONDITIONING .
TEMPORARY SERVICE OR POLE
UNDERGROUND n POWER 0
ROUGH WIRING 'Heating and Vent.
TRENCHES IJ FORMS Ei STEEL REINF. n
FLOOR SYSTEM
BOND BEAM ❑ STEEL REINFORCE rl
SHEATHING
FRAME AND FLASHING
LATHING t IN in OUT El
PLASTER, BROWN COAT
STRUCTURAL, FINAL Elertric
HEATING. VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC. FINAL
BUILDING. FINAL ea r
-7,---
0
05844f 15 10/06/78 5.50 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT — �/
P.O.BOX 1200 COSTA MESA,CALIFORNIA 9ZBX..6
agINIMINIW APPLICATION FOR ST'RUCT'URAL PERMIT
For Applicant to Fill in Comple±Lely — Use Ink OnlyBUILDING. REC£I V�Cy /j�'DATE RECEIVED DATE I/U •.
Win/R ESS .c' 4 56 L .- C` - / —l!/'�
1 \ rA\ 1+ LPERMIT NO.
OWNER�s-\'I)A . A\\ L Lb Us`S1tlal Ct A.P. NO. i • — i.�
MAIL `` `1 BUILDING ,�..��jj //'
ADDRESS IG�9S::dl ill,.�Yvhj \`r`C�(t ADDR �7,,,Y Ln '/ 6y,2_ 0 r
TE
CITY ` r).'� ��IL"sG t. . NOL' fl 4 TRACT # a LO BLOCKS
`! NEW AD' ALTER REPAIR MOVING OFMOUSH
CONSTRUCTION
LENDER IVO AJ L '
BRANCH r / �a e,y,.�. _1 //����l (Alt OWN R A / 1 Iona ciAi t V 1 ./sn -"
ADDRESS VALUE
ARCHITECT TEL. USE S
OR ENGINEER NO. ' NIk.
FIRE
ADDRESS ZONE TYPE GROUP
t APPROVED
CONTRACTOR Ownc. ,.— 6.t t fa BY DATE
ADDRESS ZON NO.OF USE OF NE
TEL. PLANS` / BUILDING
CITY NO.
J/
F
STATE CITY YARDS APPROVED VAR S APPROVED
S LIC.NO, LIC. NO. MAIN BUILD] G ACC SORY BUILDING
(FROM C/LS Ti
W r .SIZE / / NO.OF BLDGS.
p. OF LOT (...E-zE. rc Icr, NOW ON LOT FRONT ri FT.
a USE OF
en EXISTING BLDG. R.SIDE 4' Or (0 FT.
CO / //
FSeparate permits are required for L.SIDE /d,. FO FT.
electric,plumbing and heating work. i //
I' REAR /7 F-0 FT.
f._
F BUILDINGWORK TO USE OF AND BE PERFORMED
DISTANCE BET. BET.MAIN&
GMAIN BLDGS. ACCESS SLOGS.
Q
(] VAR.qW DATE
Q ' �jlf Err VAR.
ye APPROVED
APPROVED
/`Q. i11� ATE ! O 7
a (� �
m
Cl. I hereby acknowledge that I have read this application and state
N
Cdthat the above information Is correct and agree to comply with r
03
a' all laws regulating building construction, and I shall not employ
Z any person in violation of the workmen's compensation laws of
X the State of California.
I hereby certify that I am properly licensed as a contractor under SQ. FT. a
the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses aro in full force and affect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: _
am exempt from the provisions of the State of California Business 'a
VALUATION PERMITo
and Professions Code, ' ' on 3,Chapter 9. FEE $ e0 Q
CI
Signature of --�.
oO PLAN CHECK $ •--^ c
Permittee -F�• \} �1� ) $ 5ao�_ TAXE r �� F
.y
Authorized Age TOTAL PAID $ 5'6-0
JOB ADDRESS Santa Cruz Circle
GENERAL CONTRACTOR BUILDINGL$EM(I N0. 4317-1
Blue Haven Pools DESCRIPTION of WORK Pvt. Swim Pool
JAP No. 412-061-32 LOT TRACT FIRE ZONE VALUE $4,500 on
INSPECTIONS Signature Dote GROUP J TYPE ITT ZONE R-1
Pool Location 3•w-2 SUBCONTRACTOR PERMITS ISSUED
QDate I Number [Signature
Forms
Main Drain
Steel Reinforce
Elec. Bond
Approvalrilingalto Cover L �_ - ;tiring' I. • D•t - 4i ., 31'
Underground Electric anirMIIMINIMMEM
Gas Piping Test —"
--- Plumbing
Filtering System Lines ; /'�// a ! -io') . 70 aAr•5
nierl _,!�/_
Backwash Lines and Recep. aa�%!sa '/1�/i / 0
Electrical Final "'QC- _ •3-77 MEM
Heater and Vent Final
Filter System-Final I
Backwash and Recep. Final • M11111111111
Fencing Final
Annrnuel fnr Fi.,icn /QC_ s•3.71
•
Pnlu
437.1 nFC 10-76Fw-UU 632* ***=148.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
REC I� VE.p BY /66-ho-
AJE RDECEI0D' DAT ISSUED
BUILDINGADDRESS /D�� < -771 � h..{! en/ Olt/ f/ 7 '/D- to
/ / ��77 mm// P. T
I A.P.NO. of—tom - .3.
OWNER, 4 A r �'7�j1 n
BUILDING�jl�7 7t p L�` LI
MAIL ADDRESS CC// �r�(� '/
ADDR 5 �Q�n--Pf� / / �}
CITV�/20 "f7( / TEL. TR ACT(�(0.7., LOTS/ BLO K
//![f-�J.E3r/ NO.
CONSTRUCTION NEW ADD ALTER REPAIR MOVING f1FMr1l IRH
LENDER ✓
BRANCH
OWNER Ali ADDRESS
(//,/rr�,(//��/1JLJ�J V E
ARCHITECT TEL.TEL. � USE /-LIZ . $
OR ENGINEER'- . PA — O // Il�i
�j � \/�_ ZONE TYPE ROUP
ADDRESS
/��y ) APPROVED
CONTRACT ALS �/ BY DATE
ADORE 1 gffff_ _____ �Llfy / J y� %f
CITX•X-� /0....J •'C=///A7Pr'P NTEV-5- 7- 7 1"'�ZONE /]/ PLAN$Z BUILDINGNO.OF USE OF S /�_i ,r/'
it STATE q� CITY ) YARDS APPROVEDMAIN YARDS A/PPROLV/E D/
LIC.NO.
Al SIZE (NO.OF BLOGS.
OF LOT / � � NOW ON LOT (FROM FRONT C/L STREET)G ACCESSOR FT BUILDING
00
FT.
a USE OF "')
4 EXISTING BLDG. R SIDE FT. G.CO FT.
//
I--.
Separate permits are required for L.SIDE FT. MAI
.� FTA'
Ci electric,plumbing and heating work. REAR FT. �1// ( ( �'/ //
W n FT.
[.. E F BUILDING AND WORK TO BE PERFORMED DISTANCE BET. • BET.MAIN&
GIa MAIN BLDGS. ACCESS. BLDGS.
A VAR..Is DATE
..1C.U.P.# APPROVED
APPROVE �L/V/�-1I q�
1»wCilY 1
>, _ay � 44/C DATE /2- / 7
IX
w
p I hereby acknowledge that I have read this application and state n
N
p$ that the above information is correct and agree to comply with
m
O. all laws regulating building conatructlon, and I shall not employ
Z any person In violation of the workman's compensation laws of 2
y„Wthe State of California. m
/'�c,//
3 I hereby certify that I am properly licensed as a contractor under ( 6.5 SQ. FT. &
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro
Chapter 9, and that such licenses ere in full force and effect,or I THE PURPCGE OF ESTABLISHING A PERMIT FEE ONLY: n
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ e
and Professions Code,Division/3 epspter 9. en
//(y ar (�..�
Signatur - // — / %��j PLAN CHECK $ /� osiers
Tg•l •
Perms �� 'L�/ TAX $ a.
/ '/CJ s� '�-t U
Authorized Agent TOTAL PAID $
'LbWNER GBAgoWt Charles DATE 4-23-73
,kiJOB ADDRESS 1059 Santa Cruz Circle BUILDING PERMIT NO. 36524
GENERAL CONTRACTOR Bill Dietz DESCRIPTION of WORK Aluminum Patio Cover
AP No. 41p-061-32 LOT J TRACT V FIRE ZONE VALUE $ 64o.00
?'INSPECTIONS Signature Date GROUP J TYPE VM ZONE 121
SOIL PERMITS ISSV,ED
GAS SUBCONTRACTOR
kyr Date I Number Signature
` 'WATER Plumbing
,ROUGH PLUMBING
PROP. SWR. LINE I]HOUSE CON. ❑
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER
ROUGH WIRING Heating and Vent.
TRENCHES ❑ FORMS STEEL REINF. 0
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN In OUT in
PLASTER, BROWN COAT
STRUCTURAL. FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL �/
BUILDING, FINAL tad_ 11 rl:1//�ry�
36524 73PA 001394::' _.. :x:7.50
� rf-
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
REEIytED BY [DATER CE�IfV�Ej� D�T�E ISSUED1{ �
ADDRESS
d�9/ , z C v , i • �/G1- ./ eC -N / gi- 3 -
OWNER /�L/ ff,...--7,1"; I/,{-r'�r't/ A.P. NO. / -Mr. �`/'�� '{F/�/u�l9JA
MAIL ADDRESS Zed 09411,--
Z
��%� "'�` vZill /
BUILDING ADDRESS��U / J ' C" v v
0-0 CITY V----- NOL S57 T TRACT C'JC7f LOT 3I BLOCK
zZ % Y�� NEW ADD A1TFR REPAIR IMOVIN(: DEMOI ISH
< CONSTRUCTION /
O Ul LENDER 'L
J O BRANCH
-I cc/-�..yAO�
N OWNER v
< w ADDRESS
lll J /VALUE I�s.
-m ARCHITECT TEL. S �f /�4 (�crN ,t�_—/ $ Q
Q OR ENGINEER NO.
U Q' FIRE r]'�
w 2 ADDRESS ZONE TV E sr. GROUP L./
SL uI APPROVED //J�� ! �//
// ( e7I BY �(/ DATE 7 pj3, -�
J O CONTRACTOR /n v Y �J
03 z
71 cc ADDRESS / 6/ // C 77
j�'
w ` vv /�j .{/ZONE NO.OF USE OF NEW .4T�0
Z- O S ATE f ��/CITVO ���! YARDS PLANS
O -t./BD UILDING
AIR DS APPROVED
N cr LIC. NO. �•'( / LIC.NO. /5 MAIN BUILDING ACCESSORY BUILDING
D O (FROM C/L STREET)
SIZE G G NO.OF BLDGS.
OF LOT JJ77c I NOW ON LOT / FRONT FT. FT.
USE OF //t �.�{{
EXISTING BLDG. / L R.SIDE GI-CT. FT.
I-• SIZE OF 2d NO.OF n�
Z NEW BLDG. - ROOMS STORIES L.SIDE Ct"'� FT. FT.
U EXTERIOR WALL ROOF
��JJ C/'
_ COVERING COVERING REAR c/ FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN&
CL MAIN BLDGS. ACCESS.BLDGS.
DATE
Q0
% r r7 ` �/' �+/J C URP# n APPROVED
Ct C �V /f `Z-z� _ay
APPROVEG�//�// DATE9-0;3-73
O �//277
I-
C.) I hereby acknowledge that I have read this application and state
✓ that the above information is correct and agree to comply with 6-'0CC all laws regulating building construction, and I shall not employ
I"' any person in violation of the workman's compensation laws of
CO the State of California. m
to
ZI hereby certify that I am properly licensed as a contractor under SO. FT, 6
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: 0
CO
am exempt fro. • pr.visions of the ate of California Business
and Prof essio awislon 3, C tlrr •/ VALUATION / CO
4.e.
j PERMIT FEE $ / - O
Signature o I m
Permittee ��. �� V $ Fn Q / PLAN CHECK $ E
u I 7 n-o I o
Authorized Ag t u.TOTAL FEE $
inntit HELTZER ENTERPRISES-COSTA MESA VAIE 9-2b-b9
JOB ADDRESS 1059 Santa Cruz Circle BUILDING PERMIT NO. 30886
GENERAL CONTRACTOR Some DESCRIPTION of WORK Residence W/Attached Garage
AP No. - LOT 31 TRACT 6638 FIRE ZONE . VALUE $ 29,563.00
INSPECTIONS Signature Date GROUP I & J TYPE V ZONE R-1
SOIL NI5 y--R---2U SUBCONTRACTOR PERMITS ISSUED
GAS Date Number Signature
WATER/WI�ic/y--13 ?v Pluptbinq a �O
ROUGH PLUM ING u -i 1- 70 �C�J //I '/�/^i ✓-IX's/rye 07��!/�
PROP. SWR. LINE HOUSE CON. FA .5' 7-7O //1 �% �� ;.Y!/, .4.-e-7 56;9,6-
SPRINKLING
SYSTEM :::JJI��� "'GGG"""---���"' f
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING `v1s S 7 0
TEMPORARY SERVICE OR POLE
UNDERGROUND 0 POWER E I
ROUGH WIRING^ 4s-% 7, 7o t. Heating a Yell,
TRENCHES N FORMS /1 STEEL REINF. i (,.7-70 Ij/Zited /I-t' Ede,
0--,. /Q �7G
FLOOR SYSTEM fie 4-15-- 7a AV/�11f4YDr ateet E1de, .7'Ty-2-7 /7/75"
BOND BEAM 5 STEEL REINFORCE 5 /
SHEATHING (/$/(D.
FRAME AND FLASHING ‘49i4.
LATHING — IN Ai OUT } //� /.7.-
7
PLASTER, BROWN COAT (�/' g'//k7 -e
STRUCTURAL, FINAL cy ,j� EIl e,t is
HEATING, VENT., AN A.C., FINAL y J/t1^7 r/flf� /�y,(/[�/J , ,(!GC/. �,'4:- 0 ,�/.,7�,�$—
PLUMBING, FINAL AND GAS TEST b�('/�//3)-`�r ®T/''L��
ELECTRIC, FINAL
BUILDING, FINAL Ii f y},t t
- 30886 Doli 12 69c»Sn00 423* ***152.25
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 '
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIyf D�g�' DATE RnE2 DATE ISSUED
BUILDING
ADDRESS 1059 Santa Cruz Circle �J.6� 7� �i7 SEP 2 61969
Heltzer Enterprises-Costa MesaPERMUtfdQ^
AP NO
OWNER r,tin
MAIL 740 No. La Brea AVE. BUILDING /D5 y C'
ADDRESS ADDRESS
z LU TEL. 213 6638 I 31
R 0 CITY L.A. Cal. NO. 937-2171 TRACT LOT BLOCK
I- Z
Z < CONSTRUCTION United California Bank NEIN DD ALTER REPAIR MOVING DEMOI LSH
1- LENDER 67
o-m Main Office
J 7 BRANCH
-1 in OWNER ' ?
m J ADDRESS 6th and Spring, L.A. - � VALVE //C%(e;-may/
CO ARCHITECT TEL USE SOL it 42V I
J N OR ENGINEER Frank Gonzales No.532-6878 - A[//,//
Z ¢ 1336 E . Cha XTh. ranOa Cal. ZON
ChapmanTYPE .1"/ GROUP `S
W Q ADDRESS P s g r
d w APPROVED
W Z CONTRACTOR George J. Heltzer Si Assocs. BV DATE
Jp
MZ Same as above
J w ADDRESS
t1ZONE INO.OF USE OF NEW Single Fara.
Z F TEL. PLAN BUILDING
CITY NO. R1 2 Res. w/att.Gar.
STATE CITY YARDS APPROVED YARDS APPROVED
{Wn K LIC.NO. 201098 LIC.NO. 1707 MAIN BUILDING ACCESSORY BUILDING
SIZE INO.OF BLDGS. (FROM C ^TRE ET)
OF LOT NOW ON LOT FRONT sJ-FT. FT.
USE OF
EXISTING BLDG. R SIDE 7. I F1. FT.
I- SIZE OF NO.OF
ZZ NEW BLDG. ROOMS STORIES L.SIDE 5—FT, FT.
Oir EXTERIOR WALL ROOF
C.1
_ COVERING COVERING REAR FT. , FT.
-I USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
CL
C- MAIN BLOCS. ACCESS. BLDGS.
Q Residence with attached garage VAR.+ DATE
O C.U.P.# APPROVED
I-
Plan No. ii ' • 4�108 APPROVED D 2/b
/'J ]n
Z �a q i/1 DATE / 0/ '" /
O WI A-
VI hereby acknowledge that I have read this application and state
7 that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ 4 /Q 37/r any person in violation of the workman's compensation laws of
(n the State of California. 5� b
ZI hereby certify that I am properly licensed as a contractor under ��� SO. PT.T)`/�" 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:
CC
am exempt from the provisions of the State of California Business VALUATION ��� m
/491 --i----t-
� -
and Professions Code Division 3,Chapter 9. PERMIT FEE $ �
Signature of / � r0 0 e '� m
3
Permittee $.9 PLAN CHECK $ r /-5 E
Authorized Agent 4/ / / /3 FEE $ u
G7 4. /�3(p TOTAL $ /X2..2-C---