HomeMy WebLinkAbout792 SCOTT PL - Building Permits PROJECT ADDRESS: UNIT:
OWNER'S NAME: 790 SCOTT PL CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064956
ADDRESS: DELORES 6 EARL BIVEN
6352 SIERRA ELENA RD PERMIT NO: B 064956 PLAN CHECK NO: N GOVT: N SUPP : N
IRVINE
CA 92715 CONSTRUCTION TYPE: 5—N PERMIT TYPE: SIR PURPOSE: ALT
AflCHlENRESS: REG.NO.:
( ADDRESS: UNIT: JOB DESCRIPTION : REROOF COMPO 0/COMPO (GAF 20YR) SQFT: 5, 250
PERMITTEE: CLAIM VALUE: 5, 250 . 00 CALC VALUE; 5, 250 . 00 GROUP OCC: R-3 /M-1
ADDRESS: ACTION FIRST ROOF CARE ( 714 ) 841-7663
18352 GOTHARD ST COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UHC
FI
HNTTNGTON ?EACH CA 92648 �r�r*�6�6�E#+r*�r*,e*�r******* -�r*�6*** ***** *************y6****************************+6*
LICENSED CONTRACTORDECLARATION: I hereby affirm that I am licensed under provisions az Chapter 9(commencing with Section
7000)of Division 3 of the Business and Processions Code.and my license is in lull force and eflect. Z ON ING REQUIR EMENTS
CITY LIC.: STATELIc.:502900 ClASS:C 39 SETBACKS
Date: Signature: MAIN BUILDING
ACCESSORY EAILDING
WORKERS'COMPENSATION DECLARATION: I hereby a0bm shall have a certificate of consent to self-insure oracertificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: 1042000-93 EXP.DATE: 09/01 /94
COMPANY:STATE FUND PARKING REQ: PROV: PARCEL; 42417105 ZNE: REF NO:
❑ Certified copy is hereby furnished. LH Certified copy is filed with the city Building Division. PLANNING NOTES>
-i
>
Date: Applicant: *********************************************************************as*********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is tar one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS
I certify that in the pertormance 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 California.
ZONING APPROVED BY DATE: i
Dale: Signature:
NOTICE:If,after making this declaration.you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY : DATE •
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby athrm that there is a construction lending agency for the performance of the work for
which Ibis permit is issued(Section 3097.civ.CI. APPLICATION ISSUED B Y: .
LENDER: DATE:
********************** **'* * F**i *** mss'
******************* *********
ADDRESS: ********************************i *+f. . •
.� � M-*******************aF**********
LEGALIZATION:N F E t ., Y 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 MECH dIC FIRE SMZP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 81 , 00 . 53
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business S M I P/NON—RES
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 live hundred dollars(5500). ISSUE FEE
I, •
as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> 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----> 81 , 53 0 . 00 i'.. 0 . 00 8 1 . 5 3 81 . 53 Jj . 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• 81 . 53 OVER/SHORT• 00
for me purpose of sale). 00 PMT PLUMBING ELECTRIC F\tCHANIC FIRE SMIP/TOT GRADING E�LAN—CHECK
I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 . 53
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the ContractorsState License Law). I am aware r 7
thatproof of their Worker's Compensation insurance should be provided to me. ***'K'***'***'*'x'**********'**'*'***'*'*'**************'************************ *********
❑ I am exempt under Section: B.a P.C. I N D I V I D U A �, F E E BREAKDOWN •
tot this reason: TYPE QTY D E S C R I P T ISO N UNIT COST /TOTAL COST
Date: Owner:
I do hereby eerily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 5250 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 ' 5, 250 . 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 •11
these provisions.
41
Dale: Applicant: C.
•
I hereby certify that I have read this application and slate that the above information is correct.I agree to complywith all city and county -, y
ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned . /t
n
property for inspection purposes. 7 " 'f
Date: Signature:
Driver's License or Social Security
1641.46 When—Building:Green—Code Enforcement Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit$� Date I Inspector APPROVALS Permit ?k Date Inspector
1 1. Temporary Electrical Service or Poe 52. Pool & Equipment Location I
2 Soil Pipe•Undrgrnd. 53. Sire! Reinforcement
-i
3. Electrical Cnndu,t Utility-Undrgrnd. I^ 54. Forms I
4. Electrical Condurt•Undrgrnd. 55. Electrical Bonding I
5. Stee' R.inforc-ment 56. Rough Plumbing & Pressure Test I
-
G. teictr.ce. LF EH Gind. � 57. APPROVAL TO COVER-GUN'TE i •'
7 Fnotros 58. Electrical Conduit Undrgrna.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test I
9. V:atcr P,peLlrurgrnd• CO. Backwash Lines,P•Trup, Unurq':id. I I
10. Structural Floor System ! 61. APPROVAL TO DECK I 1-
11. Prop"ty Sr-ren Line & Ha uce Cgnnr conn 62. Backwash & Receptor-Final _ - -1
H. S..we7 Gip 63. Heater & Vent-Final
x-13. Ho.,f Drairr. 64. Plumbing System . Final 4 -4
1 1J.. .Ru, ! P,ur^h n3 III:I 65. Elcctrical•Firal I
I75 Ra____ !ectrica'•Conduit I 66. Solar System-Final - r -_
l 16. Rough Electric Vhring 67. Fencing &Access Approval
I 17. Rough ' ['irg 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 i
20. Ra.. n Factor„ Prep:ace 1 APPROVALS Permit -t -I I !
r -4_--
21. Ducts, in Structure
70. Underground Hyde I
1
22. Ducts, Venti.atin
g 71. Product Pip;ng G Gas .:Oil
23. Gas oine•Houah & Test 72. Underground Fluah. ---J--_ '
I _ r_
24. Roof Fremir.g 73. Undergrnd.Storagr Tank C I Gas 0 a.
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling IStructurail & Morocoat 75. Dry Chemical •
27. Frame art! Flashing 76. Dry Standpipe I
28. Lath rge. Sd n3 I 77. FIXED SYSTEM E if:AL -
29. Insulation 78. FIRE PREV. FINAi
30. Drys-.ail Oeiling HEALTH DEPT. REGUIRE:.:E;T
31. P'.aste+ 8rov:n Coat 79. FINAL INSPECTION I I- - - -
32. Electrical Power Meter•Final 80. FOOD CERTIFICATE ISSUED I I_
33. Final Elrctric ((�� /
tslotes: ..,`8'....L� 3 _ ask '(y ti 1
34. Final Heating& Air Conditioning ,.� �`
35. Final Gas Pipe-Test
,t -2.1 -�
36. Hood or Canopy C'17 �s -_,___ _ -If at
37. Final Factory Fireplace s '
38. Final Plumbing ✓0,/
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
--1.
44. Landscape Irrigation System
45. Sound Attenuation I
-1'
46. Handicap Regulations
_
47. FINAL STRUCTURE & BUILDING (Z_f-Z3 �,.4 ---- . - - - 1
48. FINAL PLANNING {
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 790 SCOTT PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 064956
OWNER'S NAME: DELORES & EARL BIVEN
ADDRESS: 6352 SIERRA ELENA RD PERMIT NO: B 064956 PLAN CHECK NO: N GOVT: N SUPP : N
IRVINE
CA 92715 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
3 ARCH/ENGINEER: REG.ND.:
ADDRESS: UNIT: JOB DESCRIPTION : REROOF COMPO O/COMPO (GAF 20YR) SQFT: 5, 250
CLAIM VALUE: 5, 250 . 00 CALC—VALUE: 5, 250 . 00 GROUP OCC: R-3 /M-1
PERMITTEE:
L ACTION FIRST ROOF CARE ( 714 ) 841-7663
ADDRESS: 18352 GOTHARD ST COMMENTS: SMOKE DETECTORS REQUIRED PER THE 1991 EDITION OF THE UBC
HUNTINGTON BEACH CA 92648 *********************************************************#***#*sm �( TC
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMEN T $ O�E E�`-"
7000)of Division 3 of the Business and Professions Code.and my licens is in lull force and effect. $ E T BACK S
CITYLIC.: 045135 STATE LIC.: 502900 S: C-39 REQUIRED
Date:—//aS —Signature:— MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I t have ac i reale consent to sell-insure or acertificate of Workers FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
Compensation Insurance.or a certi ied copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PaLlum: 1042000-93 EXP.DATE: 09/01 /94
COMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 42417105 ZNE: REF NO:
0 Certified copy is hereby furnished. IS Certified copy is filed t 'Ty >
Building Division. PLANNING NOTES
// fl• 93 0. >
^— Date: AppgcanC \, #*######*******************#*######******##*#*###*#*###*###*##*#*######********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: phis section need no completed it the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQU I REMENTS
I certify that in the performance of the work for which this permit is issued.I shag not employ any person in any manner so as to become
subject to he Workers'Compensation Laws of California. ZONING APPROVED BY
DATE;
Date: Signature:
NOTICE:If.atter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance o1 the work for APPLICATION ISSUED SUED BY: , s DATE; �, �/!.,
which this permit is issued(Section 3097,Gill-C). ********************** ' • - ***** -- ,r Q **#*****#*lH
LENDER: *#****************************************** **************#*******************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER OECLARATIDN: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,atter,improve.demolish,or
repair any structure.prior to its issuance.also requires the applicant for such permit to file a Signed statement that he/she Is licensed PERMIT 81 , 0 0 . 53
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 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(S500). ISSUE FEE
I, as owner of the property or my employees with wapes as their sole compensation, wig do the work, and the BUILDING—DIV—> 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————> 81 . 53 0 . 00 0 . 00 81 . 53 81 . 53 . 00
does not apply to an owner of a properly 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 : 81 . 53 OVER/SHORT: . 00
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 , 5 3 .
❑ and Prolessions Code: The Contractors'State License Law does not apply to an owner of property who builds on improves thereon '
and who contracts tor such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *****.x,**,*,*.*******.*,*****.*******.***,N,**,***************************#***�F***1********
that drool of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. IND I V IDUAL F E E BR EAK D OWN ,
•
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 5250 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 250 . 00
25534 and that I or any future building occupant witt/will not(circle one)need to comply with said state codes and the requirements for a END OF FE1S
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant: EXPIRED♦
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 '(T[Q(I1 Yte 1r" C` S
ordinances and state laws relating to building construction and hereby a of representatives o1 this city to enter upon the above mentioned
property for inspection purposes. 01 001� 5nEiTe-001513859 Tot C1.SC1.5:,_ G)_�LV Sj¢ DATE: 11/17/Q3 TIRE: 13:23
c'— Date: /�n • 9 , Signature: Dote
�C
Driver's License or Social Security dr .9
164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL & 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-Uridigrnd. • 54. Forms •
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding •
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 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 tI
63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe•Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas OOil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT ,t
31. Plaster Brown Coat 79. FINAL INSPECTION '-
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED _ I
33. Final Electric Notes: t . •
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
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System t
45. Sound Attenuation%,, /1
46. Handicap Regulations' -P-1-R-E fl
Incomplete Inspections
47. FINAL STRUCTURt& BCJILDING •
48. FINAL PLANNING r I ••
49. Electric Release to Edjson. t� t •y
50. Gas Release to Southern p1iitornia Gas Co i J
51. CERTIFICATE OF QCC4PpNCY
No. -bate;
i
VOJECT
ADDRESS: UNIT:
OWNER'S NAME: •
590 GRAND HAVEN CI CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062490
ADDRESS:PIERCE RICHARD A TR
590 HAA
VEN CIR A92626 PERMIT NO: B 062490 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: 5497533 REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION : T/OFF SHEATH REROOF W/COMP SHINGLES SQ FT: 5, 650
PERMITTEE: CLAIM VALUE: 5,650 . 00 CALC—VALUE: 5, 650 . 00 GROUP OCC: R-3 /M-1
Ao0RES5: HEIDT ROOFING CO ( 714 )997-9729
544 N EARLHAM COMMENTS• SMOKE DETECTORS REQ PER UBC *1210
�(�pp�y�i�T((`�p�` ((``yy qQ9 (.,q ********it*MMM**MM*MMMMM*MMMM *M*MMM***MMM***************M*MMM**M**MM**MM******M
LICENSED CONTRACT the Business 0N: I hereby affirm that I am licensed and tftff a �Cattier 9(commencing with Section Z ONING REQUIREMENTS
0001 0l Division 3 of the Business and Professions Code.and my license is in lug force and ellen.
11
CITY LIL.: STATE LIC.: CUSS:
040317 471812 �y. C
Date:_GI 1— C1 3 signature:_ — SETBACKS
9
_ewN MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have 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 3800,Lab.C)' LEFT: FT IN RGHT: FT IN LEFT FT IN RGHT: FT IN
POLICY NO.:285-930000508 EXP.DATE: 01/01/94
COMPANY:STAFPARKING REQ: PROV; PARCEL: 41802222 ZNE: REF NO:
Certified copy'slay furnished. ❑ Certified copy is filed,with the city Building ivision. PLANNING NOTES>
CoApplicant: 1 >
Date. l �� � - 9 % _ _l Bf if lFM iF iE iE iF iF*1Eif lElEjt BEifiFMiF iF it iE ie MiFM iF itltiPlf if iF it if iF ikkiFiE iF if ie MieiE iEkiE iFlEit if k*iE iF if if Kit Mit ik it if ik iE iE if jF if iE it iF iF iF 3t
EXEMPTION FROM WORKERS'COMPENSATION OECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E:-M E N T S
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 California.
ZONING APPROVED BY DATE:
Date: Signature: +
NOTICE:It,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE:
Code.you must forthwith comply with such provisions or this hermit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for J • --.>>�
which this permit is issued(Section 3097.Civ.CI. APPLICATION ISSUED BY: — DATE• 060793
LENDER: **************i*********************** ****************************************
ADDRESS: LEGALIZATION:N F E E ' U M M A R Y STRUCTURAL SEGMENT:Y
OWNER BUILOER DECLARATION: thereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTr IC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of 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 life a signed statement that he/she is licensed PERMIT - 81 . 00 /• . 57
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES
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(SS00). ISSUE FEE
I, as owner of the property or my employees with wages as their sole compensation. will do the work. and the BUILDING—DIV—> 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----> 81 . 57 0. 00 0. 00 81 . 57 .81 . 57 , 00
does not apply to an owner 01 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.II,however the building or
improvement is sold within one year of completion,the ownet will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 81 . 5 7 OVER/SHORT: . 00
for the purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner o1 the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 . 57
❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon ,, e
and who contracts for such projects with ansuracesh)license pursuant to the Contractors'State License Law). am aware ***************************************.****************************************
that proof of mein Worker's Compensation insurance should be provided to me.
❑ 1 am exempt under Section: B.s P.C. INDIVIDUAL FIE E BREAKDOWN
/
,
for this reason: TYPE QTY D E S C R I P T I O N.'/ UNIT COST TOTAL COST
Dale: Owner: p
I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 5650 REROOF BY VALUE RESIDENTIAL N020NE 1 . 00 5, 650. 00
25534 and that I or any future budding occupant will/will not(circle one(need to comply with said slate 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 from1•J 7
these provisions. �T et ••i tr
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 - -' styr _ /
ordinances and state laws relating to building construction and hereby authorize representat of this city to enter upon the above mentioned '- -� - _
/propenv for inspection purposes. _ _
�// n/7 �L( xx
Date: C¢ �( —�3 Sigoawre:J�M.I/1 f DS 0014049E-00140499 TOT 81.57
/ Driver's License or Social Security+:
r DATE: 06/07/93 TIt1E: 08:.`a8
1641-46 White-Building:Green-Code Enforcement;Canary-_Applicant;Pink-Revenue:Goldenrod-Assessor
A
iv STRUC710N AND PLANNING POOL& SPA j
APPROVALS Permit r'. Date Inspector I APPROVALS Permit d? I Data Impecto.
i
1. Temporary Electrical Service or Pols _ • 52. Pool & Equ;;;neat Location
2. Soil Pio Undrgrnd. - 53. Steel Reinforcement I 71
2. I:ectncal Gond jt: Lit'ty•Unergrr,, --- 54. Forms
-4• Elcctr'cal Condu-t-tl^d•••i i . ' I I 55 !l''•ct•ical [locoing I
_ I - --- --- --- t
i5.-E tn: Reinfo-cart-it I- -- 5u. Flovgh Plumb rg 6. 71, .1,re 7-.4.-t7-.4.-t - -_.
.1 4.- -----�, I � •
-- -- ---- -- - -- -rte.
G. Electrical LIFER Grad - I 5/. APPROVAL TO COVEN 611P'ITF '
--1 58 Electrical Conduit Unw ina. I
moi.--. - --- --- -- - - -- -- - ----- - - 1 -- ---i-- __- .
-8: foundation • : 59. Gas Pipe, Cl UrUrgri'd .Test
9: gate• P pe•Urd rG rci. 63. ELc:.v sh Line . P • r.t.,
--- -I -I----t-- --- - - - - - --- - - --- - '-- -
10. Structural Floor System i 61. APPROVAL TO DL CK I
11. Property Server Line& Hoi-=C Cu .c
nrr • n I
av62. 9.Gc s.ash & 4r :,I Ii
12. Seer Cap `---! • ---- ------ -- -t-
i --� -'
63. He ter & Vent-Fin
'
13. Root Drains _ •�r - 64. Plumbing System • FiiI I - -
_ _ _ __Y -_-_ __ _ ___--1---
14. Ppug'r P.5r'Sng -_-_- -
--
-I 65. E'eatrical Fi^.a' _._-
1
15. Rough Electrical-Conduit 66. Solar System lint:'
16, Rough Electric Wiring --- I67 Fen&ng & Access .App-cu•' - _ _--~--
17. sough Wiring S.gn I I 68. APPROVED FOR PLASTERING I
18. Rough Electrical-7 Bar CrI'rg I 69. POOL/SPA SYSTE'"S FINAL I
19. Ro• uth Heating & A r Cc,-d t -g -_� _"yI FIRE DEPT. Ft�QUIRU:ENT - -71-- -_--1 -- - -
20. Houih Fyttorr FireO'acr t 1 r '- ` C ?..' : APPRO-`7ALS: _'Perruu t - 7. •
. r ---T-,.I•j T Y-•r --tom
--
21. 'Ouch,inStrutturr • i . -• i •- - 1 ,� 70. LInclergrddAd:lv7qt, 1 i
22. Ducts,Vpntititing• ,- t 4 `- , IPra`s 'd I I - - --
23. Gas Pipe-Rough& Test r .I I-7 7-7•4•72 n •eo ' ' Flu-ft •<Ur .
24. Roof Fram,n f • -
9
. I i � /'J73.Z1ndergrnA;slaia�;i.+4 ','Gas l U'
25. Root Sheath n-, : . G�..�/ (f� •
//, • '74. ,ad H t.,.- - �- - -- - ----� -
7iyiL lYw!! -y -_
26. ,'r" Bai Ce,hng iSb,tctu+ t- Pruecut -- _ a., 75 t]ar Cnem.::a 1
-r--.-:-'--- D ---r----r - - ---7-- -�--•-�
27•:game and Flashinc„ 5 ti 76. Dry Stanc:c+ w ' _ I -
38. Lathlng lk 58ing - .i'- ' �� �� 77.'`FIYEO SYSTEM1.1CiNAL `._ t (`" '--ac' - - -
'29. Insulation 'x - a I 'x a:I 78,r'FIRE PREY. FIN.+'. -' I
C --- h1 - - - -' - -- -
`37. D'Y:.eu•.�a lira rr ` 1-__-- - _ ---HE7\LTH WEPT, REOU1R1-f.l :.., _ -
�i. PiasterBoc:;rCoal •` r,•- - ;1.79. F INA I. IV3?tCTI(3rre , I /
_+t----- -�S -_-�..- tI _-_ x -- _ - __ ,_
_132 ' cctncal.Po :e "Jlet<t=r I ^.j '30.-','OGD Ct hTIfty.(_ I .;LtD
,� - .-- - =r -�-^- _ - - Vit.-- G .:1- -
:93.K mat-Electric a t NoMs:� ( S. �.� fl- -- -
,. _ ..--.____-_ _- _ _ _- -_T_- _ ._ - - .__ - .
34.r.F'nar Healing& Ar•Condrt on.tie • yi _
35.E 'nil Gas.Pipe-Tett {H�/ ` ///i.-
1 - 1� I; 4.1 - - - -
36. Flood ortCanopY •= `, . ' 1 ' �I} .
-_•_ __ __ t__-__ � I I' 1 T =-_
37. Final Factory Firepl,ce - t I t -. rl v
38. Final Plumbing • I,' - '• - -
• r _--
•39. Water'ServicetPinai,. I '.` " -- ` r
- I - c - -- --
40. Gas Service-Final r r-r 3 1 • _
41. Solar Ddmes*ie-Final • _ _ - - _ . -
4 t 1 -�n - •
- - - -42. 6cckflon Presenter - 1 I
43. Backflow Irrigation ' -, j t
ir
I r
44. L_indstx'e I- gation Sy st,•T •, r / 'S se0A-- - o l cy4 -----
l�: r 6 yh31 -- --
45.'Sound Attenuation; _ ' r I - _
46. .rdicap Regu!at,on; --- -
N_ _- -
11. FINAL STRUCTURE & BUILDING --
i
-
• -{-i: - --
48. FINAL PLANNING '
j (I
49. Electric Relepse to Edison • --11�- _h" '�'- - ----� -- -
i- - I I -- i - --
50. Gas Release to Southern C.litcrnia Gas Co I - =
51. CERTIFICATE OFOCCUPANCY II t
I
NoDa __ --
. Dan:
.1
April 28, 1987
City of Costa Mesa
Development Department
P.O. Box 1200
Costa Mesa, California 92628-1200
RE: La Mancha Apartments, 778 Scott Place, Costa Mesa, California 92627
Gentlemen:
I hereby authorize the City of Costa Mesa Development Department to provide all
drawings and information regarding my property at the above captioned address
to the LAW OFFICES OF RAYMOND UTIN.
Thank You,
I cille Pimental
LP/dg
,-
O
June 9 , 1987
City of Costa Mesa
Development Department and Building Department
P.O. Box 1200
Costa Mesa, California 92628
RE : La Mancha Apartments , 778 Scott Place, Costa Mesa, California
Gentlemen:
The undersigned was the designer of the said building and was
the person who prepared the final set of drawings and specifications
which were submitted to the Building Department and which were
approved and permitted.
I hereby authorize and request the City of Costa Mesa Development
Department and/or Building Department to provide all drawings
and information respecting and regarding the above-referenced
project to the Law Offices of Raymond Utin.
Thank you for your cooperation and courtesy.
a_ /
ROY KnifIT
9301 Vi toria
South Gate, California 90280
213-569-8559
CONSOLIDATED
To: o (2Cs 1 >� I REPROGRAPHICS
Attn: M cEpt
• BLUEPRINTING
Add: • XEROGRAPHY
• INDUSTRIAL PHOTO
• OFFSET & LETTERPRESS PRINTING
From: G< , • DRAFTING SUPPLIES & FURNITURE
Time Due: ,cc • MICROFILM SERVICE
Invoice No: � �a k3y • PIN GRAPHICS
• CAD SYSTEMS
SPECIAL INSTRUCTIONS • OVER 50 PICK UP AND DELIVERY CARS
ANAHEIM ! IRVINE
127 s53H3318TER AVENUEUr 3187512 268N 0'
LAGUNA HILLS TUSTIN
581-2563 838-2855
23271 VERDUGO DRIVE 560 W. FIRST STREET
PRINTING DIVISION
751-8212
130 McCORMICK AVENUE#107
J
CITY, COUNTY PICK UP SHEET
PICK UP FOR PoLiiI IL. (Mt
THEIR INVOICE NO.
CALLED IN BY
PICK UPT 1_I�1O r_i (// t" /,
PERSON T SEE U
ADDRESS
l
DEPART ENT (Ai/JA !�a (1h 1
DESCRI TION OF ITEM TO BE PICKED UP / 1L(.1'
_ 1
Fe)
V
NOTES (EG: SCALE, SIZE, OTHER) I '
WORK REQUIRED BY CLIENT 'DPI/U6! -17 i-(/d!
lej(46_
t.
0//$0fr7 Ain
ORDER TAKEN BY: ( �t'I i( U.L
DATE g ,/1I• c_- TIME CALLED IN 7 o
COMPLETED TIME INVOICE # 1 (3; c
�' c „ C.1
JA �-
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
• CITY of COSTA ESpA ccIONJST CTION PERMIT PN}�T�°�� ] TRACT NO. LOT NO. UNIT NO. 3351 9/18/56 5.00 TL
. Prraject Address 7176 ..Y"O/ i"PL/ P r o�J �"� r I 1
Applicant's Mailing address i -y _ TYPE OF CONSTRUCTION
❑ CONVERSION ❑ ❑DEMOLISHNEW U ADD U ALTERATION U REPAIR
•
❑ OTHER A.P.# I Zone •
Owner's Name '.ii/' 1 I e.„. Phone ••Sr '7S1 DESCRIPTION OF WORK/USE OF BLDG.
i Address (°3 fl- . /C CVe,M rtes/, ,a -tr✓yatl/ S Main Building: . Accessory Building:
NA Zf y.�7/S. Z
Arch/Eng. License No. P — TYPE OF PERMIT ❑ GRADING •FOUNDATION LI STRUCTURAL E Front 0
Address -- n?)l ❑-35/70 ❑ OTHER TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N
/
Contractor's Nam - L iii Phone IC Right N
+�w1 /�\ � Address(mailing) /5-33 hi /tie 4/.cJ .4n/AAC/m PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Q
VCONSTRUCTION TYPE VALUATION$ _ S Left
City License No. s93a ZONE GRADING CU.YDS. ACRESE
LICENSED CONTRACTOR DECLARATION Ping. Ref,* Parking Req./Provided
0
I hereby af r that I am licensed under provisionsBusnssf Charterro9i ns eand Remarks: -- — Planning- Notes: 7 1536 M
with section 7000) of Division 3 of the Business and Professions Code, and (� t AUG
my license is in full farce} d e act- / - RFCEWEU T
Licens- Class L.'- Licen, No.0 /76--C72
DO Date — -.11/ Signatur. ail.../ 4 ( /as ' PLUMBING' /� FEES A \f 1n]1rsCC vE AU " 4 9 RIF •
WORKERS'COMPENSATION DECLARATION Bar Sink /1 $hOwer� • tLtI:TKICALD FEES
1 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 / Automatic Washer Transformer 0 15-50 KW
3800, Lab, c.) p'/,I Backflow Preventer Se lte Sink
Policy No. Orr 1'"� Company2)eAver =NJ Backflow Irrigation �� Sewer Cap0 50+ KW
Construction Pole Sub.
Certified copy is hereby furnished. l
1/'�J .-Cer�f ietl copy is filed with the cit N fill l D' ai Bathtubs / Sewer Connelai 1 / Cooking Unit Meter ❑up to 100 amps'
v Date /- �/4 Applican�/1�/ � •c'Q� lam//
-.- EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers / Solar IectQrs Dishwasher Meter Clover 100 amps
(This section need not be completed if the permit is for one hundred ($100)'or `1
less). Dishwasher / (Solar l l Dryers OGas DElectric Sub Panel
I certify that in the performance of the work for which this permit is issued I - -
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar,Tank / Fan Motors 00-1 HP 0114-8
Workers' Compensation Laws of California.
' Date Signature Floor Drains j /, Swjmming Pool w/Spa / F.A.U. inc.Solar ❑9-15 HP 016-15+
NOTICE: If,after making this declaration,you should become subject to the `\ `l
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks/ 1 Y Urinal / Fixtures Microwave
comply with ,such provisions or this permit shall be deemed revoked. TTT ��`
CONSTRUCTION LENDING AGENCY ,
Service Outlets "Water Closet
I hereby affirm that there is a construction lending agency for the performance / _— Device Boxes Pole Light
01 the work for which this permit is Issued (Section 3097 Clv, C.) Interceptors Water Heater
Lender's Name 7 0 ' Outlets Range
Lender's Address Kitchen Sink Water Service - - Switches
OWNER BUILDER DECLARATION \ Sign
I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash 1Garbage Disposal ;Standing Sections
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,Improve,demolish or repair P—ITrap Laundry Treys Generator ❑0-5 KW ❑5.15 KW-1
any structure, prior to Its issuance, also requires the applicant for such permit • Trash Compactor
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 \
therefrom and the basis for the alleged exemption. Any violation of Section -a
7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). \ ' i
LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 •Isue Fee $ 3
compensation, will do the work, and the structure is not intended or offered \ - . Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor'sMECHANICAL FEES
License Law does not apply to en owner of a property who builds or improves _ --
thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: _
employees, provided that such Improvements are not intended or offered for a Hood or Type I ❑ •
sale. If, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or im1-3uct• Under Grund-
prove for the purpose of sale). - Building Approved ByDate
❑ I, as owner of the property, am exclusively contracting with licensed con- . Refrigeration System Application Issued By Dat
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 . ' 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractors) license pursuaht to the Contractor's License Law). I am aware that � ■ System Repair/Alteration BUILDING PERMIT $ SMIP $
proof o/ their Worker's Compensation Insurance should be provided to me.
PLAN CHECK .$ PERMIT :C
0 I am exempt under Section B.& P.C.for this reason :. Fire Dampers
PLUMBING $ r L� ISSUANCE $ J
_
Date Owner Heating System = Ducting Registers • PLAN CHECK 25% $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above ■0-100,000 0100.000 a
information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ GRADING S
and state laws relating tot building construction,and- hereby ion duthoriee yfor PLAN CHECK 50% $ MICROFILM $
repre-
sentatives of is city to en er u on the above-mentioned property for
Inspection s. ////�� ,{bq,,' , ^ , '.� / MECHANICAL $ TOTAL FEE $
Signature/ .rL.CLL / �4.1/L0- Date 9 /2/--9G
Drivers' License or SS ir Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • - -
CONSTRUCTION AND PLANNING POOL &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. 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, 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 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
1,9. 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 0 Oil
•
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding - 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE 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: /2.'2-87 Lga-cotz.) L,G•.t'
34. Final Heating& Air Conditioning f2- t4-97 Nor eros.(- liFO
35. Final Gas Pipe-Test (-7.fiV C4rttaA. Ik Pus- 4o4 VPC. L.60
36. Hood or
37. Final FactorytoryFireplace Fireplace
38. Final Plumbing
39. Water Service-Final v�
rr� _
40. Gas Service-Final
I 71
41. Solar Domestic-Final
fYS
42. Backflow Preventer '5 Cs •
171 •
r 343. Backflow Irrigation
r -
44. Landscape Irrigation System r
.45. Sound Attenuation 5,
;46. Handicap Regulations
'47. FINAL STRUCTURE & BU1'LDIN9
48. Special Requirements Completed
49. Electric Release to Edison -
•50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER Pf1RRRTS0111PAM. F - • DATE 7-15-58
JOB ADDRESS 7 T-, R$a Scott P1. BUILDING PERMIT NO. 7101
GENERAL ONTRACTOR 0. Z. Robertson VALUE $ 22,528.00
136-W1-05LOT 18 TRACT 292Lt FIRE ZONE DESCRIPTION OF WORK Tri pi Px
GROUP H & J TYPE 5 ZONE R2 PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
d �� DATE NUMBER
Trenchves FormsX Steel G--6 1 -4 b'
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing ,rR /q-,lj`ff
Lathing, In Out)( t." -L- q-1-775S
Plaster, brown coat g 3.& /0-2`,!1.ifN
Underground soil L.W. W/G Pipe Test f3K $"6-cir J
Top Out
Furnace / M/S 9-/cj;1
Gas-vemr/ / 3-57(/ vim. / e/Ar'w ,,;)c"„ ;)c” /z-9 ,e r per/o7---->" /9-se /4S,S_ e.- i
`f
Rough Plumbing /WS -/9- ie7---->"rpea err 7z8-.Sr? /Sk.C,A3 .•L___
Cesspool Septic Tank 1
?ran. Swr. Line House Con. 01,81. Swr. . a.," ,
Sprinkling System
Heating Final NM-fS 3-41.2-t
Plumbing Fixtures, Final 4M ��-�J 1{"r/
Final Gas Test
Construction Pole 141CA4& 'CT; Err-. ./-/Stc_S`rl Qi i
Underground Power / .
Rough Wiring �s/J 7-L i_G 0 7/ • L . NK\_
Fixtures, Final f, `7; /f
OCCUPANCY Ik' / /y.rf_,-v
Form 210-5M-1-57
7RR_9Cl_99 Scnt.t. P1 _ i 7101
OWNER ROBERTSON, PAUL E. DATE 7-15-58
JOB ADDRESS 790 Scott'Place - BUILDING PERMIT NO. 7101
GENERAL CONTRACTOR 0. Z. Robertson VALUE $ 22,528_00
1lli,..,21-0 LOT 18 TRACT 2924 FIRE ZONE DESCRIPTION OF WORK Triplex
GROUP H & J TYPE V ZONE R-2 PLAN NO.
INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED
DATE NUMBER
Trenches Forms Steel
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing
.Lathing, In Out
Plaster, brown coat
Underground soil W/G Pipe Test
Top Out
FurnaceVents
/
Gas � / //
Rough Plumbing ,//J//S/In2 9-/9-ce ��Q ta4 tot-/-0_-t-7- 7-tit-SW _./'I C/V- [-
Cesspool Septic Tank J i
Prop. Swr. Line/ IA/House ContlekSt. Swr. 5{-6-5r n
Sprinkling System
Heating Final /a.y_,t-2
Plumbing Fixtures, Final �q'�� // In.-.4-4-8 .It
Final Gas Test lie. /9,.-ry, \
Construction Pole
Underground Power
Rough Wiring 7-Auei►'I 9-//Y 6R /14/n- G -/17 9 2-2 7-SR' . 702 0
Fixtures, Final / //-7 S lid{
OCCUPANCY /a.-+?-6 V 1
Form 210-5M-1-57 Tr-,.nl ex 171 m
.OWNER Robertson, Paul: E. DATE 7-i5-58
JOB ADDRESS •2 Scott ' • BUILDING PERMIT NO. _0
11Gf,,,.No E6N1E�RAL CONTRACTOR O.Z. Robertson VALUE $ 22,526.00
17\Y -0 LOT 18 TRACT 2824 FIRE ZONE DESCRIPTION OF WORK Triplex
GROUP H & J TYPE V ZONE R2 PLAN NO.
INSPECTIONS DATE PERMITS ISSUED
SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
Frame and Flashing
Lathing, In Out
Plaster, brown coat
Underground soil WIG Pipe Test
Top Out
Furnace
Gas Vents A
Rough Plumbing 4219S/F77 CJ-/9-1/4SW/C.PG nF.Y-o,=r 7—at-SW Zed, /C6 ' / I y
Cesspool Septic Tank' q / 1
Prop. Swr. LineL4.thiouse Conyµ/St. Swr. 3-G-t—P C' / i
Sprinkling System _ ttt///
Heating Final _Ala c y-ei-S-P
i
Plumbing Fixtures, Final . O I
Final Gas Test tO-- /j-%5
Construction Pole ,
Underground Power
Rough Wiring rn/e/!y 9-/F-Vg 2-?./.9.0 -O-L,TP 7-22 -a In 7� /
Fixtures, Final rib" /-7-"Sr ' W
-OCCUPANCY .4a 4)1/¢-./1 f
'
Form 216-5M—I-57 lrlplex � 71 ni
•
9101 _.
LII. III Lut2 'v ,al'a
COSTA MESA BUILDING DEPARTMENT , '-7-a-.s`s 0 L.
P.0.BOX 317
COSTA MESA. CALIFORNIA FINANCE DEPT.
FOR APPLICANT TO FILL IN APPIrICATIONT''FOR4PERMIT
BUILDING 1t$ _9O-Qt Orer€4 f.Rrc BUILDING
ADDRESS
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
�{�/ RECEIPT NO. PERMITPE// NO
OWNER�ccu.L ,C I Ieq CiGC(Y se,,,, (�/I� O. ([ c�G//rye
MAIL VI ( W • I 41 J� 1 (0S$i.. IISIC5� By re-RE < " '/�3'f
ADDRESS �/� (�.10b-.s /c r /J
CITY CS 1St- lCc LG., TNO-LI O10JJ ADD EISS 7 tr.
O —`'Z f(D'/il
ARCHITECT j . ,T
T �' LIC.
OR ENGINEERLiu , pQyd my, NO. COSTA MESA. CALIFORNIA
FIRE i
ADDRESS IA)**1 I W r( , ` J C. ri. ZONE
/� I�'�(��y CITY LIC./fin L.C.8, / ZONE///�\.�� � NO.OF TYPE GROUP
Tom.?. i ,cs'^'R.b��U NO. // / I %' PLANS V V -
CONTRALTO 1
T1T I Lv. p C� (_TEL. APPROV Cr'
1 V AT M
ADDRESS NO. BY ` d221 a DATE IS
LEGAL
L CORRECTIONS
DESCRIPTION OIt BLOCK TRACTg�p
A.P. NO. // a-
IOC//- I0 /•� FG, V rr
SIZE 1 S, ^C I Y .7 / /I NO.OF SLOGS. (,G PPC 1 ® • • D
OF LOT C!' ^ I Now ON LOT ♦` �� 1
USE OF CITY O: !$1'A MESA
EXISTING BLDG.SETBACKLINE FROM '9/ /� r� i� 11 SUBJECT TO UG. DEPT. REG.
CENTEREROF STREET � J REAR YARD C
SIDE YARD RIGHT S LEFT 5 -7 p
DESCRIPTION OF WORK gY�. fS DATE /-a J 9
PLA T:CH Qiyy7
NEW I/ i ALTERATION II ADDITION
REPAIR MOVING IVfI DEMOLISH 1
BUILDING O1 O� NO.OF
SIZE
1-1 LI I`� ROOMS STORIES '
EXTERIOR WALL s*4A4LCI ROOF
COVERING S IOIL.1 COVERING OG
USE OF NEW ( r[�
BUILDING T .
PL..CX - (I.A-�41�\Q (.Qti,�{-,>
_15/3 /Y a r
.5? .l n 7-517
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUE.
TION. 1/\ 22221,, VALUATION
SIGNATURE OF \`J PERMIT FEE S y�`
PERMITTEE \
S 2 Z)5 2- PLAN CHECK S L/
AUTHORIZED AGENT L TOTAL FEE S 63- 41/4F