HomeMy WebLinkAbout280 SANTO TOMAS ST - Building PermitsPir r_
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Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -
CITY OF COSTA MESA IT NO TRACT NO.. - LOT NO. BLDG.NO. '
CONSTRUCTION PERMIT � � �� T
Applicant's Mailing Address N 7 3.7 54 P.PC'• bR �/-�Ps-✓1. 9a TYPE OF CONSTRUCTION U NEW 0 ADD _U ALTERATION U'REPAIR - - - . •
- -
�R0 'St to.7YKiM�(S C./11. - . ❑iCONVERSION '❑ DEMOLISH 0 OTHER •
Project Address /' /, q _ . - -
.7i7�- '4.1n A`,yC-y Phone Gya- /GSI • DESCRIPTION OF WORK • •
Owner's Name - U' - U •
- ' • - 'ZONING REGULAT a •S?"-, I
•
Address S'9ME -- r TYPE OF PERMIT 0 GRADING FOUNDATION. STRUCTURAL A.P.qy. . ZONE _ + -s NI: p •
el. i^:,,
Arch/Eng. "' License No. ` - ❑ TENANT ❑ ELECTRICAL ❑,PLUMBING 0 MECHANICAL • PLNG.REF,REF.* BUIL 'p -`
Address I ^—�/ •- .0 OTHER TO BUILDING - cETg. n\ n /l� le
//"�MI)� L�I�/} PhonePROPERTY LINE REAR VA-lei. O PMiI 1� V
Contractor's Name /I �I 7�P-�G S�/ PROJECT DESCRIPTION SQ. FT. - OCCUPANCY - !! 1Q j ff/
Address(MailiNg) y737 'Scf.Cere1 YR, G ,,+r/1'/. VL I.5 • CONSTRUCTION TYPE VALUATION$ $D� .LEFT SIDE YARD RIGHT SIDE V/A+�-T aV - "`c
License NO �_ •�� 3�`'-�/ ZONE GRADING CU.YDS. ACRES PKG.SPACE REQ. PROVIUEO /•
• OF ',s
LICENSED CONTRACTOR DECLARATION Remarks: . ' • -. • STREET WIDTH •PARK FEE$ �• ,MSA
I hereby affirm that Lam licensed'under provisions of Charter 9(commencing
with,section 7000) of Division 3 of the Business and Professions Code,and I •• • SPECIAL CONDITIONS: I '
' my Iicense'is in ifu11 force and'effecct - - _ - ,
License c ass `- M i'ea-vnetf i - 1 + Lice se No. 9a 1 3'/,). ' PLUMBING
^:,+e 3 ' Signature
Bar Sink Sewer Cap - ELECTRICAL ,
<c?gKERS'COMPENSATION DECLARATION •
reby.affirm that.l have.a.certificate of consent to self-Insure or a celrtificate - Backflow Preventer i • - • - Sewer Connection - - -^ - Automatic Washer - Meter_❑over 100 amps
of Workers' Compensation Insurance, or a certified copy thereof (Section . . _ , , r - - - -
. 3800, Lab. C:) Backflow Irrigation Solar Collectors _
Construction Pole Sub Panel; I 1 • ' •
Policy No. - • Company '- • i _ Cooking Unit ' Sub Pole '
BCertified copy Is hereby furnished. . Bathtubs i ' / Solar Piping 1 a i
Certified copy is filed with the city.Buildingslvision. , • Dishwasher Motors -1 HP 01''/-8 •
/ ;
Date ' Applicant 1 _ _ 1 Clarifiers :7 SOIar Tenk
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION _ • - - •- -- - ' Dryers ❑Gas OElectrid Inc.Solar 09-15 HP 016-15+
. (This section need not be completed if the permit Is for one hundred($100)or Dishwasher Swimming Pool w/Spa
less).- Fan • 'Microwave '
I certify that In the performance of the work for which this permit is issued,i Drinking Fountains Urinal i _
shall not employ any person In any manner so',,'aaas to beco a subject to te , F.A.U. Pole Light
Workers' CQQm}en tloni La sof lifornia.`/ '' �h ' Floor Drains , Water Closet; I • -
• Date 9/z/ Signatureyou should
tl/ � / - •
Fixtures 1
-NOrkers' f,after-making.this declaration,you should become subject to the • Floor Sinks. _/ .Water Heater -- - . 7 1 Range_-
Workers' Compensation provisions of the Labor Code, you must forthwith - Q'- Device Boxes
comply with, such provisions or.this permit shall be deemed revoked. Gas Service Outlets Water Service • Sign; ,
CONSTRUCTION LENDING AGENCY - ' . - - -
' I hereby affirm that there is a construction lending agency for the performance Interceptors ' •
, � I • , ' Outlets Standing Sections
of the work for which this; permit Is •issued (Section 3097 Civ, C.)' Switches •
'
Lender's Name ' - Kitchen'Sink' - .. Trash Compactor
Lender's Address - -
OWNER BUILDER DECLARATION - Lavatories. 1 . , i Garbage Disposal .
I hereby affirm that I am exempt from the Contractor's License Law for they _ , Generator 00:5 KW 05-15 KW • ' •
following reason (Sectlon-7031.5 Business and Professional,Code: Any city or , P-Trap . . - . • _ I ,
county whichl requires a permitto construct,alter Improve,demolish:or repair - Transformer 015-50 KW '
any structure,prior to Its issuance, also requires the applicant for such permit Roof Drains' " . .. - . ' - _" • ' , i
file a signed statement that he/she is licensed pursuant to the provisions of 050+KW, --
Contractor's License Lawl(Chapter 9 (commencing with'Section 7000)of - . ' ' - - Reinspection Fee $15
Ision 3-of the,Business and Professions:Cotle)"or•that he/she is exempt ' • Showers - Reinspection,Fee $15
erefrom-and the basis for the alleged exemption. Any_violation of Section ' - •'• , - Meter Oup to 100.amps ; 1 'Issue Fee: '$ 3
7031.5 by. any applicant for a,permit-subjects 'the applicant to a'.civil •
__ . '
m�aenalty of not more than five hundred dollars($500). j ., i Service Sink I Issue Fee '� I $ 3 Zoning Approved By ' • Date
'LJ I; as'owner of the;property or'my employees,with wages.as their sole I _ ' 1 ,/
compensation willldo the work,and the structure Is not intended or offered _ ,MECHANICAL - Application A roved B
i for sale (Section 7044, Business-and Professional Code: The Contractor's , PP PP Y �� - + •Date q�/ �p
. License Law does not apply to an owner of a property'who builds or improves , Boiler ' . Refrigeration System i i 77,
thereon, and who does)such work himself/herself or through his or her own • - . I Application Issued By - 1 :Date
I employees, provided that such improvements are not intended or offered for j , 00-900,000 BTU ❑100,000 BTU. .
• sale. I however, the buildingor im rovement is sold within one year of com- ' Duct-Under;G round
P Y , ' _SUMMARY OF FEES •
prove , the owner will have the burden of proving he/she did not build or im- 1 , I. , f I v
Lirove for the purpose of;sale). ,. ' Duct-Structural System Repair/Alteration BUILDING PERMIT $'' 3 ' SMIP ' ' $ ' rs
I,as owner of the property, am exclusively contradting with.licensed<on- 1 I '
, tractors,to construct the project (Section 7044,Business,and.Professions.Code:- .j. Duct-Ventilating, _ _ _ I - .PLAN CHECK, $, : PERMIT. '
The Contractor's License Law does not apply to an owner of property who qq • ISSUANCE ; $
' builds or Improves thereon,and who contracts for such projects with a con- ' • Exhaust System 0 Multiple 0 t I. ,. PLUMBING $ I' j
' tractor(s) license pursuant to the Contractor's License Law). • • GRADING 1 $
0 tam exempt under Section i i B,& P.C.for this reason , Firepl/Fact.Blt. ICBG* , I 1 'PLAN CHECK- 1 $ . . I
I r I ELECTRICAL . $ I, -
Date Owner' I I I ' Heating System& Ducting 1 "S� ; l
PLAN CHECK 1 $ MICROFILM $ • '
i hereby certify that-1 have-read this'-application and state-that the above 00.100,000 BTU 0100,000BTU - •
-
informa[lon is correct. I agree to comply with all cd 'and county ordinances I. 01 I 'MECHANICAL $ TOTAL FEE $
yenta•and.state es laws relating to buildingeteconstruction,and hereby authorize repro- i .
of this city, enter cup n the above-mentioned property for Hoodor TypeI . - 1' •
inspection purposes. ' Canopy, Type II ❑i Reinspection Feed $15 PLAN CHECK , .$. LESS i
IADVANCED PC � $
• Dri vetura yF/'
Registers Issue Fee I $ 3 1 , ?
_ - FINAL FEE $ as
CMF 0865-46 rev.12/82 white-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - -'. - --
- -
F./.. : ,
j_ CONSTRUCTION AND PLAN NGS , _ PO :SPA _ li
p, $ Date, a Inspectr. Ij • Date ` Inspector
• 'APPROVALS Permit# {� i oAPPROVALS Permit.#
' 3. Temporary Electrical Serviceor,Pole '.:` - . - -
r 52.- Pool & Equipment Location - _
2. ,Soil Pipe-Undrgrnd: - > - 53.= Steel Reinforcement - ' li
3. Electrical Conduit Utility-Undrgrnd. ,‘ " I 54: Forms - -ii '
4. Electrical Conduit-Undrgrnd. , , 55. Electrical Bonding - IF
ft
5. Steel Reinforcement , .� - 56.. Rough Plumbing & Pressure Test I. '
6: 'Electrical UFER Grnd. a - . 57 APPROVAL TO COVER-GUNITE
7. Footings - - o 58. Electrical Conduit-Undrarnd: - :i'; ,
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test" 'I.
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑'Undrgrnd. 1
10. Structural Floor System •`- , „ 61. APPROVAL TO DECK - • ; - .
11. Property Sewer Line &,House Connection. 62. Backwash & Receptor-Final `q
I:
12. Sewer Cap . , 63. Heater &Vent-Final - ' . -`.l
13. 'Roof kDrains i - - 64. Plumbing System - Final h
14. 'Rough Plumbing , .. 65. Electrical-Final - ' •
15 Re-ugh-Electrical-Conduit ,66. Solar System-Final -
"'!,6. Rough Electric Wiring r - , . , ;,, I - "-"- 67. Fencing & Access Approval. c -.
t7.: Rough Wiring Sign , ;, I - 68. APPROVED FOR PLASTERING
' 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - Il
' 19. Rough Heating & Air Conditioning I FIRE DEPT. REQUIREMENT sl.
.20., Rough Factory Fireplace ' ' APPROVALS Permit#
21. Ducts,in Structure. • 70. Underground Hydro
22. Ducts, Ventilating ' - I 71. Product Piping OGas OOil
- -.
23. Gas Pipe-Rough & Test -52. Underground Flush
24. Roof Framing • - - 73. Undergrnd.Storage Tank 0 Gas 0 Oil '
25 •
. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural),& Monocoat - 75. Dry Chemical .
27. Frame and FlashingI 76.. Dry Standpipe -
28. Lathing& Siding - t ' ' 77. FIXED SYSTEM FINAL - .
29. Insulation-: - - : - .78: FIRE PREV. FINAL
- 30. Drywall Nailing Notes:
31. Plaster'Brown Coat ,
' 32. Electrical Power Meter-Final - '
33. Final Electric _
34...Final Heating& Air Conditioning - '
35. Final Gas Pipe=Test - - - .
36. Hood or Canopy• ' -
37. Final Factory Fireplace" - , ,
38. Final Plumbing -
39. Water Service-Final
I
40. Gas Service-Final i
41. Solar Domestic-Final • Id_.3-r3 - ,
42. Backflow Preventer ; ' i X77 WC , •
43. Backflow Irrigation - ; •
.
. 44. Landscape Irrigation•System. I.
45. Sound Attenuation' - ' • 1 • 1:
46. Handicap Regulations' ' ` t! •
- 47. FINAL STRUCTURE &.BUILDING
48. Special Requirements Completed ' - 1 -
•
49. Electric Release to,Edison..• - -_ - . - 7
50. Gas Release to Southern California Gas Co -
51. CERTIFICATE,OF• OCCUPANCY - -
•i
No Date
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FNSTALIATTON TNER-MATTON: CUIPONTENTS SALE PREVIEW
i'Co. of people in frmily f•of PTh-i-rt. Panels/type fl 2/t/X
elk.)tal gals. used daily --60
Storage tank g:Li(W .
No; hot water. tanks / Gas X Electric Module 3 e)
. .
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Racks d__ degree 3 0
aConventional tauk location(s) JP° 6....4/2/1-6 -- run solar loop - -
. .
Fico,1 type S--/91,f,4:7S- Condition ‘06,16 Crossoye_r
Height j S Pitbh 94;._ Facing / fcb ConV. 1--arkFr--gat
Attic: yes )( no , Open Beam: yes no X Electrical upgrade A/G2 ft
Cease Avadlable: Yes No X. Heater EL:nit:et H /./4 . .
Electrical outlet from storage 5 ft. • Rack Enclosure Aid
Round trip pipe run: Pipe Enclosure - ,(/b
Solar loop /OC..) ft. Other
Tank Crossover ft.
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%;aJECTADDRESS: 280 SANTO TOMAS 'Si',44.) UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 0589Ub
OWNER'S NAME: HARVEY, ROBERT D
ADDRESS: HARVEY PATRICIA A PERMIT NO: B 058906 PLAN CHECK NO; N GOVT: N SUPP: N
280 SANTO TOMAS ST
COSTA MESA,CA 92627 CONSTRUCTION TYPE: V-N PERMIT TYPE; STR PURPOSE; ALT
642-9621
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT, REROOF W/COMP SQ FT: 2, 500
ADDRESS: UNIT:
CLAIM VALUE: 2, 500 . 00 CALC-VALUE: 2, 500 .00 GROUP OCC: R-3 /
PERMITTEE: ROBERT HARSEY ( 714 ) 642-9621
ADDRESS: 280 SANTO TOMAS ST COMMENTS: SMOKE DETECTOR RQUIRED IN THE HOME
COSTA MESA CA 92627 ************************** *************TF*SH***+E** ******>Ex-*********+r**********TE
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS
CITY LIC.: STATE LIC.: CLASS:
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C).
PCMY : EXP.DATE: PARKING REQ• PROV; PARCEL: 43920208 ZNE; REF NO;
COMPANY: PLANNING NOTES>
Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
>
Date: Applicant. DEVELOPMENT SERVICES R E Q U I R E M E N T' S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less).
certify that in the performance of the work for which this permit is is ued.t 5 I not employ any person in any manner so as to become ZONING APPROVED B Y DATE:subject to the W eri mDensatian Laws of California.d �
/7
Date: Signature: BUILDING APPROVED BY ; ----.44.. ' DATE:
TICE' 1. er making this declaration,you should ecome subject to the Workers'Compensatio ovisions of the Labor `'�/t,
Code.you must forthwith comply with such provisions or this permit shalt be deemed revoked. ..----
CONSTRUCTION
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE• ��% t
which this permit is issued(Section 3097,Civ.C). **********************1t************* ' . *************s************ '/- . • . • **
LENDER: ******************************************************************* ***********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE"• SNIP/RES) GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 ...--. 5O:
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed ' SNIP/NON= RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 15500). ISSUE FEE % i^.
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN—CHECK TOTAL .I PAID A
UE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 O , O O 0. 00 5 4 , 50 54 . 50 D O O
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through /'
his or her own employees,provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED• 54 . 50 OVER/SHORT: 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN-CHECK
for the purpose of sale(.
54 . 00 , 50 '
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business -
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon is
and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware *"*'*'****************'*****************'**********************************************
�A that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
IN tam exempt under Section:BP7044 B.B P.C. rf
fortthis aso ' ALL WORK BY OWNER / TYPE QTY DESCRIPTIO N UNIT COST' TOTAL COST
tare:_/-/ ��Z- � � oder,— A I► SFR 2500 REROOF BY VALUE RESIDENTIAL NOZONE 1x00 Fi.
1 2, 500 . 00
l do here y certify that I am aware of andund stand the requirements of Calif nia Health and Safety Code Sections 25505,25533,and END OF FEES
2553 114 d.WF-I-er'arryfm re mMing occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions,
•
. Date: _ Applicant: /
I hereby certify that I have read this application and state that the above intormation is correct.I agree to comply with all city and county - A
ordinances and stale laws relating to building construction and hereby authorize representatives of this city 10 enter upon the above-mentioned
property for ins➢ tion Qr7--. //4,1P -6
/` ,e ,x .
Date: ( Z Signature' // ' //
Driver's - ense r Social Security t: _ _ -
1641.46 White-Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor • ..-
_ _
1 CONSTRUCTION AND PLANNING POO 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 t
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
I
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap . 63. Heater & Vent-Final
, 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final '
15. Rough Electrical-Conduit 66. Solar System-Final •
16. Rough Electric Wiring 67. Fencing & Access Approval i _
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
r: , •: - .
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 &fest .72. Underground Flush
24. Roof Framing - • •73. Undergrnd.Storage Tank 0 Gas 0 Oil __
25. Roof Sheathing t1, el fribL /Jl/ 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat _ - - 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding _ 77. FIXED SYSTEM FINAL •
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat l , ' I. 79. FINAL INSPECTION ,
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning ail
35. Final Gas Pipe-Test .11.1111111111 -
36. Hood or Canopy Mill
37. Final Factory Fireplace �Mil
38. Final Plumbing
39. Water Service-Final - '
. t
40. Gas Service-Final ' .
41. Solar Domestic-Final
i •
42. Backf low Preventer i -
I .
43. Backflow Irrigationt- O-y' .4,„___14 - .,/ .e^
44. Landscape Irrigation System 511c tsi-r7 ' Eft-/c--
45. Sound Attenuation
46, Handicap Regulations
47. FINAL STRUCTURE & BUILDING ter s' c t - 6��
.� c • C`
48. FINAL PLANNING - 'l
•
49. Electric Release to Edison '
I,
50. Gas Release to Southern California Gas Co 1 I I
51. CERTIFICATE OF OCCUPANCY
No. Date
•
OWNER NIEMAN,�V. & RICHARD C. DATE JAM 2 1964
JOB ADDRESS 250 Santo Tomas -St./}V BUILDING PERMIT NO. 21271
I GENERAL CONTRACTOR Owner-Builder VALUE $ 15,286.00
kAP No.119-164-08 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORK Res.&At.Gar.
INSPECTIONS Signature DATE_ GROUP I&J TYPE V ZONE Rl
II Soil i� 3 PERMITS ISSUED
C Gas 7f 4/�-.? SUBCONTRACTOR DATE NUMBER
Water 3 -3C.�- y�-9 F' i/-.2-7-Cc/
Rough om. Refrig. ElAir Cond. 0
Rough Heating /175-'q-&'4 -5C ` - ) •--) pert 4( r)g1
—
Rough Plumbing
Miscellaneous G a - /g- --f, 6 V A 6 Ce,
Prop. Swr. Li liouse Con. L t. Swr. r Inn tb_f < -j---t-bi ( LAjj et
Sprinkling Syst m
Construction Pole 7%1/61
Underground 0 Power 0 . 1
Rough Wiring cbnr\ 4P1 er . :-H air=-5 t22, H OP) .-
Trenches 22---- Forms Steel Reinf. 0 R&6€ q-3_aY
Floor System i
Bond Beam 0 Steel Reinforce 0 �
Sheathing 4� ,4-20-at-
Frame and Flasliic3g-"" Ry--f-(,rJ
Lathing — In p/ Out•0---e-f-iv '
Plaster, brown coat r V3 7 /c u .
Refrig. 0 Air Con. 0 Final A�S
Heating, Final NH ,C--30-GP
Plumbing Fixtures, Final b-30 ea
Final Gas Test Mt< v y° v
Electric Fixtures, Final 0,0YJS c,,3c,.-Cc/
Building, Final /1rt f:JerCU
OCCUPANCY .
Form BU4-5M-3-63—S-B P 21271
2 271 FEE RECEIVED
*COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 2 1964 67.1)1
P.O.BOX 917 COSTA MESA.CALIFORNIA
FINANCE DEPT.
For Applicant to Fill In Completely CIF'POEIFRFMRSPERMIT
TYPE O�PRINT BUILDINGce
n For Office Use Only
BUILDING
ADDRESS
RECEIPT NO. tiEay;T N 0/
COSTA MESA, CALIFORNIA /
E jCT•'-Y• DATE RECEIVED DAT IS�9y/ED
./ 4 - Vi/
OWNER . . 4 // 2 /. - i F , s / .4 �0// -- / (lam
BUILDING �} /
/ ADDRESS �O Z� i�� . 8/J/@Q ,
FIRE ./
• ' . „ ' • ., , ZONE TYPE y GROUP /]
ARCHITECT r-+ '- TEL •�_ BTAPPROVHD Sal
OR ENGINEER - NQ. II )
ir ING
ADDRESS " ` 1..E NO.OF ^ I USE OF Nfi /, I`�
PLANE y BUILDING I ASF /
•
�J //e- t �t 1 DESCRIPTION \I 0 I` �` et /0 f" \V / V
' ADDRESS .4/1 / LC 4024 �• EXT
CITY 6° 77/. A.P.NO. // i r/ (�/ (.7,-• Q Q
NOTE: NO EAVE OVERHANG SHALL BE LESS THAN
STATE TEL. SO'TO SIDE Q REAR P.L.
LIC.NO. NO.
/ EAVES
SIZE , /w,/ft I NO.OF BLDSS. ALLOWED (U.B.C.REQUIREMENT)
OF LOT -J !, 3T/f Now oN LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET)/
CENTER OF STREETM
SETBACK Li HE FRO
FRQ NT 57)FT.L'REAR YARD / s S�I.VI.�IF i/(.p/�
SIDE YARD! LEFT - I RIGHT R.SIDE 5 'n. FT.
DESCRIPTION OF WORK L.SIDE i J FT. 6, Fr.
NEW /\ ALTERATION ADDITION REAR CI FT.
DISTANCE BET. BET.MAIN R
MAIN BLDGS. ACCESS.BLDGS.
REPAIR MOVING DEMOLISH
VAR.# DATE
BUILDING NO.OF •
. SIZE ROOMS STORIES C.U.P.# APPROVED r�.
EXTERIOR WALL ROOF APPROVED (LW yam/ Y Y�
COVERING I COVERING 9Y DATFykur
USE OF BUILDING AND WORK TO BE PERFORMED - l
4P c'c-!>A-,xsr itx,--,-,,,
fl71fn: ,w->� 6 f0/��0, -
c".... . ~i/yoz .
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 5
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION m
. BUILDING CONSTRUCT �/ AQ N
/1 �_,>/_- - 3 PERMIT FEE $ 0 m
SIGNATURE OF (/ //�!////!U/ fro
PERMITTED $ ge O/ LA C CK AS S x
/ 6 b 0
• AUTHORIZED AGENT •°�/ S O
. . - .. TOTAL FEE $ / G•
UWNtN ��+�, �• f DATE 9-10 (4
JOB ADDRESS 280 Santo Tomas -6t."/ t BUILDING PERMIT NO. 38965
GENERAL CONTRACTOR Aluma Kool DESCRIPTION of WORK Add Patio Cover to Res.
AP No. 119-164-08 LOT TRACT FIRE ZONE VALUE $ 500.00
'INSPECTIONS Signature Date TYPE V GROUP J ZONE R2
.;
SOIL PERMITS ISSUED
GAS SUBCONTRACTOR I
Date Number Signature
:' WATER Plumbing
t1 ROUGH PLUMBING
JPROP. SWR. LINE Q HOUSE CON. 0
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE _
UNDERGROUND 0 POWER 0
ROUGH WIRING Heating and Vent.
TRENCHES fl FORMS 0 STEEL REINF.
FLOOR SYSTEM
BOND BEAM n STEEL REINFORCE n
SHEATHING
FRAME AND FLASHING
LATHING - IN in OUT n
PLASTER, BROWN COAT
STRUCTURAL, FINAL Electric
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST n
ELECTRIC, FINAL I''
BUILDING, FINAL �c
PAIL/
EP 16 7�Byg. O 684 ****5 50
38965 CEP 16-74�Nt.0 6841_d******.00
a
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
For Applicant to Fill in Completely
J PP I TION FOR BUILDING PERMIT
Y DATE RECEIVED DAT ISSUER
BUILDING a g� 5151-4l70�7 A-S,S, 9�i to �.s9
ADDRESS L+ //�� �7 �y/✓ 1' [.
OWNER S . �A/S 4 A.P.NO. 1)9 IOt/—Z/A
PE �N4'+)
MAIL L ``
BUILDING ^ �.�, MV t `.
Z
ADDRESS S J ADDRESS �O \�yyw N•I__CJ ID 1�
d U CITVEtOS �q �ES' NO.(�G��v C% TRACT` } Lt .Sp BLOC
Fy TU/.LB La /
Z l- CONSTRUCTION NEW ADO ALTER REPAIR MOVING DFMOI LSH
O N LENDER Aik AJ Oa- A/
ti a
J y BRANCH S . Ind F J ae
J N OWNER re
m 1
ADDRESS VALUE r�s.V
JC0 ARCHITECT TEL. USE PA--nSe�.
Q OR ENGINEER NO
U G FIRE T
Z ZONE T PE GR1--g-lq!J
Wa W ADDRESS A ' M 1y'—miCONTRACTOR Ait/A IY /Kcal BYPROVEDDATEz8 39e icon-EG.64
J(): ADDRESS _.
W w TEL. ZON`t, NO.OF USE OF NEW/�
Z H CITY S77'rA/7n Ai NO. K P��� BUILDING /An() e UEb
wO STATE CITY 1 �S ,YARDS APPROVED YARDS APPROVED
/�•
01 O IIC. NO.a��� LIC.NO. I 7 MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OF BLDGS. (FROM C/L ST ET)
OF LOT NOW ON LOT R NT .C�t�\ (1 FT.
USE OF
EXISTING BLDG. R SIDE 'OFT, FT.
QF NEW BL arti 44 ROOMS STORIES L.SIOE r.( JFT. FT.
EXTNEW BLDG.
V CO ROOF
RIOR ALL COVERING REAR t_g T. FT.
.J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN Pr
C'
6, MAIN BLOCS. ACCESS.BLOCS.
4 .
/r DATE
O C.00ee�a .294-no C.U.P.# /J APPROVED / �7
ZROVED/ IL /1 T DATE r — /6 X71
O t/�� U
H I hereby acknowledge that I have read this application and state / g(AIe
Mthat the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
F 56
any person in violation of the workman's compensation laws of
H the State of California. Tto
ZI 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: R
am exempt from the provisions of the State of California Business VALUATION
and Professions Code,Division 3,Chapter 9. PERMIT FEE S � t•'
Signature of / \ m
Permittee VO $ PLAN CHECK $ E
/ / p
Authorized Agent Q C�n a
. TOTAL FEE $