HomeMy WebLinkAbout2828 SERANG PL - Building Permits E CITY OF COSTA MESA _
4 BUILDING DIVISION
et et)
•,,,,' -,i DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
1;1 PERMIT
° •, B03-00962
„ _
•
(714)754-5273 • Fax(714)754-4856 • www.cicosta-mesa.cams
BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2828 SERANG PL Status: ISSUED
Suite: Applied: 06/09/2003
Vicinity: RESIDENCE AND GARAGE Issued: 06/09/2003
Parcel Number: 13932111 Zoning: R1 R1
Applicant PRIEBE, BILL ISSUED BY:
Address: 955 DEEP VALLEY DR
STE 2963 Phone: 800-569-9037
PALOS VERDES,CA Zip: 90274
Owner: CAREY, SHARON
Address P O BOX 153
Phone:
MANHATTAN BEACH,CA Zip: 90267-0153
Contractor B P CUSTOM ROOFING
Address: 955 DEEP VALLEY DR
STE 2963 Phone: 800-569-9037
PALOS VERDES,CA
Zip: 90274 License: 652641
Arch : Eng:
Address: Address:
•
Phone:. Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF WOOD SHAKE ROOF ON DWELLING AND ATTACHED GARAGE, INSTALL SHEATHING, FELT AND COVER WITH 40 YEAR CLASS A
COMP SHINGLES. -
FEE SUMMARY
Plan Check: $0.00 Calc Valuation: $9,180.00
Permit: $181.25 Claim Valuation: $9,180.00
SMIP Res: $0.92
SMIP Corn: $0.00
Other: $0.00
Inspection: $0.00
•
Total: $182.17 •
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0
PARKING Existing: 0 Required: 0 Proposed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned
for a period of 180 days. •
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)7545626
2446-46(6/00)
DECLARATIONS fl,
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit Is issued.
I have and wit������....rtrtrtrtrtrtlllIIIaint in wo rs' pen tion insurance,as •uire y-section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'kOfn�pn nce car i r and et u er are �J/,jr y
Carrier: ✓✓ M u Policy Number: GD7' ec� 0J
(This section need not be completed if the permit is valued at o :hun d dollars($100)or less.)
❑ I certify that in the performance of the work for which thi-v•rm. issued.I shall not employ any person In any manner so as to become subject to the workers'
compensation laws of California,and agree that if I sho �•e o e subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisions. ,'
Applicant Signature: U Date: C 0 ---03
WARNING:FAILURE TO SECURE WO ER COMPENSATION 4,41 ERASE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100,000),IN A RI TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DE L TION:
I hereby affirm that I am licensed r ovislons of 9fb Forpmencing with Section 7000)of Division 3 of the Business and Professions Code,and mylice in lull
force and effect.Llc.# (��JJ'7/t'III Class# �1�A CC....
Contractors Signature: Date: i-- i( /�
CONSTRUCTION LENDING AGENCY: C J
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097.Civil Code).
Lenders Name: __ _ Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement Is
sold within one year of completion,the owner-builder will have.the burden of proving that he or she did not build or improve for purpose of sale.). •
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,fatsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No
8 (If yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIA' E: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Ma :ria•.nd Emissions.
• Signature: Date:
-I
CERTIFICATE OF COMPLI' C: . D AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply th :II .tate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property f• in •: tion purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Nnat r:Of Legal Owner(s) ( _ -- —O to
nd/Or Authorized Applicant ,• �(J 9 mate
CODE I INSPECTION TYPE PATE R1If11.L5 COOP INSPECTION TYPE DAME RILL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final !�5'( 208 Final Plumbing
200 Final Re-Roof 64745 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA - PE IT N �; TRACT NO. • LOT NO. - BLDG.NO. .. •
CONSTRUCTION PERMIT. - . .. .. -. : . ' %'6 YO '. -' 1 ' I 75h0 4/'./ i,,, '• 300 ' T:
Applicants Meiling Address_L--les--4-1.2.-a&-d---------_-^/ ' - TYPE OF CONSTRUCTION 1--I NEW ❑ ADD U ALTERATION U'REPAIR •- •
Al
Project Address ,2qP.�' Se r2 9LJtC riAC'r', .❑ CONVERSION -❑ DEMOLISH ❑ OTHER •- - 1
�]„
Owner's.Nam•e 7r/ �' - + Phone/• 7!-4'319 - DESCRIPTION OF WORK _ - _
\,1_) ZONING REGULATIONS
Address •�P I47, ; TYPE OF PERMIT U.GRADING FOUNDATION U STRUCTURAL A.P.sW ZONE •
a\ Arch/Eng. - _ License No. I ' ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL - ,PLNG. REF.9k ' BUILDING
- . ccrneri :Zvi CT
V Address - . ❑,OTHER - - - TO BUILDING'. - .REAR YA •
RD(TO P/LI
_..-� �-�s �n PROPERTY LINE
Contractor's Name %, F-.i 7s p�pyr Of x L''' �'N Phone r r-J 3�7d PROJECT DESCRIPTION, Sq FT. • OCCUPANCY -
CONSTRUCTION TVPF VALUATION E LEFT SIDE YARD ' RIGHT SIDE YARD •
Address(mailing) /1 33. AI ,Cion-e . - _
License No._ __per`/ �I'- ,) 7• - ZONE GRADING CU.YDS. ••ACREc PKG.SPACE REQ. , + PROVIDED ,
LICENSED CONTRACTOR DECLARATION : ; • Remarks: STREET WIDTH :PARK FEE'S
• I hereby affirm that I am licensed under provislons of Charter 9(Commenting - - . .
with section 7000) of Division 3 of the Business and Professions Code,and ; , i • . SPECIAL CONDITIONS: + . - '
my IIcense Is In full for and effect. , - - -
Lcense lass �c -C- - 3 6 ' '• LicenseN /7�r/ t - , . PLUMBING ' '
Date '�// L •3 Signature ' -vl�•r .�+- .7-/4 ,
-"ORKERS'COMPENSATION DECLARATION Bei Sink I Sewer Cap i ELECTRICAL S
ireby affirm that I have a certificate of consent to self-Iniure or a certificate_1 „, •Backflow Preyentef -.Sewer•connection. - 1 I - _. Automatic Washer ,Meter Dover 100 amps' + -
Workers' Compensation Insurance, or a certified copy thereof (Section - - - Construction Pole +
3800, Lab. C.) + ' Backflow Irrigation , Solar Collectors- , i Sub Panel
Policy Ni. 4944-iii--0" • Company ! f1 v;:4° .T4J _ -
Bathtubs ' Solar Pi m ' Cooking Unit I '',Sub Pole;
certified copy is hereby furnishe0. , I P g •
.(- Certlfvq;d copy is flied with the clty.Bulidln9 Dlvislin. - I - Dishwasher 'Motors ❑0-1 HP ❑1'h$ '
Date //-d--.1 : Applicant �'y� �A✓/: /a/''a' ..23-/Ct ; Clarifiers I Solar Tank .i I 1
EXEMPTION:FROM WORKERS'COMPENSATION DECLARATION - - - Dishwasher 1 i Swimming Pool w/Spa + r • Dryers'❑Gas' ❑Electric •- Inc:Solar 09-15'HP 016-15+ ' , `
(This section need not be completed If the permit I5 for one hundred($100)or '
less). ! - 1 — - Fan „ 'Microwave I '
I certify that In the performance of the work for which this permit Is issued, I Drinking Fountains Urinal t 1 ,
shall'not employ any person In any manner so:as to become subject to te - - , F.A.U. •�'" 1 °P0'Pole t
Workers',Compensation Laws of California.lI ; 1 i ' Floor Drains' Water Closets , i ' - '
Date Signature - •i Fixtures ! L iRange 1 i •
.NOTICE:If,after making..this declaration,you should you subject to the. Floor Sinks 'r_� -., -- ,/, . Water Heater,_ . .,•--,...04,.. 00 _
Workers'. Compensation provisions of the Labor Code, you must forthwith •! - i Device Boxes I • 'Sin '
, comply )with: such provisions or'-this',permit 'snail, be deemed revoked ( Gas Service; -Outlets 1 • ,Writer Service ,• 9 i
' CONSTRUCTION'LENDING'AGENCY ' '- ' -
I hereby affirm that there is a construction lending agency for the performance I , Interceptors - - I I ' , . . Outlets �$tanding Sections
of the work '.for which'this permit Is'issued,.(Section •3097 Civ. C)f . - 1
Lender's. Name - - ' - ! Kitchen'SinK - - Switches Trash Compactor '
•
Lender's Address ^ • ' - i • - i Garbage Disposal • j + i ,
OWNER BUILDER DECLARATION Lavatories - , f
I hereby affirm that I am exempt from the Contractor's License Law for the - 4 - - - Generator ❑0-5 KW ❑5-15 KW i - I
following reason-(Section 7031.5 Business and Professional'Code: Any city or ` - . r-Trap, , •:1 , .• + .z i i i ' ' 1 ,
.county which requires a perridt':to construct,alter improve,demolish or.repair --- y,- - •- - : Transformer ❑75-50 KW •
,any structure, prior to Its-issuance,also requires the applicant for such permit Roof-Drains( i_ - , I = ' •
to file a:signed statement that he/she Is licensed pursuant to the provisions of - ' - ~ ❑SU+KW ''lie Contractor's License Law(Chapter 9(commencing wlth•Sectlon 7000)of - + '- ' '.Reinspection Fee $15 •
I�^`(Ision'3;'of the'Business and. Professions Code) or,that he/she is exempt Showers , Reinspection Fee' $15
• „ .etrom antl the bails far the alleged exemption. Any vlolatlon,of Section _ 4 - Meter ❑up to 100'amps ' Issue. Fee: i '$ 3
'-dl'.5 by, any 'applicant for.al permit subjects'.the 'applicant to a civil -' - _ _
malty of not more than five hundred Collars($500)'.• , . ,. Service Sink, - ; •' 1 Issue Fee S 3 T jZoning Approved By •
Date
' •
LI I, as.owner of the'property or my employees with wagesias their sole I ;MECHANICAL + r
. compensation will do the work,and,the.structure Is not intended or offered • _ , Application Approved By - Date •
for sale'(Sec/Ion 7044, Business ad Professioperty de:.The Contractor's - Q �'1/ ,Z�
License Law does not apply to an owner of a property who builds or Improves Boiler -. 1 . ! Refrigeration System Application Issued By S • i Data 2O F
thereon, anp who does.such work himself/herself or through his or her Own
employees, provided that such Improvements are;not Intended or offered for ( ' '
Duct-Under Ground ❑0=100,000 BTU ❑100,0008TU' •
sale. If, however, the building or Improvement Is sold within one year,ol com- j j " l SUMMARY OF FEES ) •
pletlon, the owner will nave the burden of proving he/She did not build or 1m- I - {
rove for the purpose of sale). 1 I i ' Duct-Structural System Repair/Alteration 'BUILDING PERMIT $ - i SMTP ' I $
•
LJ I, as owner of the property,am exclusively contracting)with licensed con- , . I • I
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 1 , : I_ • ( PLAN CHECK • $ - ' PERMIT { q f
The-Contractor's'Llcense'Law does not apply to an'owner'of'property who'' -- Ze„LL(�� ISSUANCE $ ��+
builds or improves thereon,and who contracts for such projects with a con- —' Exhaust System ❑ Multiple❑ , + PLUMBING $ _
tractor(s) license pursuant to the Contractor's License Law). ! GRADING $ , •
❑'l:am exempt under Section • 1 B.& P.C.for this reason Firepl/Fact,BIt. ICBG# I •
PLAN CHECK $ j $ '
• - .ELECTRICAL' $ •
Date f - owner' - - • Heating-System& Ducting • I • MICROFILM $
I.hereby certify,that.f.have.readthis.application and state.that-the above. ., - ❑0-100,000BTU-❑.100,000 BTL. _ PLAN CHECK. $
Information is correct. I agree to comply with all city and county ordinances - - f ^ - ) - $ TOTAL-FEE ' $
•
and.state laws relating to building constructign,and hereby authorize repro- MECHANICAL ,
sentatives of'this.city to enter upon the above-mentioned property 'for i Hood or Type I ❑. Reinspection Fee .$15 j LESS 1 '
Inspection purpe�e . / y- Canopy. Type II 0 PLAN CHECK' $
Signature ."4!'X-d..,-C. �j •C���
' Registers ( Issue Fee $ 3 • ' FINAL FEE $ �J C"''.)
CMF'0865-46'rev-12/82' -White-Building Canary-Applicant;Pink-Account ;Goldenrod=Assesssooii--- -' ' '---' - _ " ... __ •_ •• '- " ' - • - - • - -«
/rPig?% -4f t./-1''&a f/O.✓
- C CONSTRUCTION AND PLAN ING " •: t'7 .7. ".^ , - : - - PPO ;PA • " - . , ,
♦;_APPROVALS Permit# ' / pp0 _ .Date Inspector. -_;APPROVALS Permit lc
Date Inspector
0. Temp
. orary,Electrical Service or Pole _ _it- ' :52. Pool &`Equipment:Location n ,,;
:2.1 Soil Pipe-Undrgrnd' _ . , 4.53. Steel Reinforcement '
73.',Electrical Conduit Utilitv-'Undrgmd. ' r: - - - ' I . 54. Forms' . - ' , - -
c 4.;Electrical Conduit-Undrgrnd.- ; , : "_ _ ''55:..Electrical Bonding. _
'5.Steel;Reinforcement j i'., ` ; ' - '56. "Rough-Plumbing& Pressure Test" • '
F6.1 Electrical OF ER Grnd: ' `- ' "' : - _57: APPROVAL TO COVER-GUNITE .
7. Footings •• a ' -58.'Electrical Conduit-Undrurnil- t - .
8.;Foundation•
_ J - s ; - ' 1/4,459. -Gas Pipe, 0Undfgrnd., Test -
9.0Water Pipe-Undrgrnd. - - 60.•Backwash Lines,P-Trap, 0 Undrgrnd.
10.'Structural Floor System "- ` , - _ 1' :61. APPROVAL TO DECK- - - -
• ,
11.1Property Sewer Line&House Connection - - _ , 62. Backwash & Receptor-Final
i .
12.'Sewer Cap; ; I i , - _ 2 7 63.'Heater& Vent-Final . -
13. Roof Drains ; i - ' , -64. Plumbing System - Final - - - .
14.jRough Plumbing, , . ' - - • • -65. Electrical-Final - • -• ' •
v
' '15. Rough Electrical-Conduit-i'- ;-1 -1-T- -- - i - J-66. Solar System-Final - - : --
16.• Rough Electric Wiring . 1 z ',. a r i .' , - - .
._ I s _ 167: Fencing & Access Approval, . - _ .
-17.hRough'Wiring;Sign. �_ i ; '
. : ;- t ' 1 : I'- ;68, APPROVED FOR PLASTERING • '
_ 18. Rough Electrical-T Bar Ceiling . I 169. POOL/SPA,SYSTEMS FINAL _
19.- Rough Heating & Ai;Conditioning I ! I I ' 1 1 FIRE DEPT;REQUIREMENT
20. Rough Factory Fireplace 1 ; ' I I 1 ! ; APPROVALS Permit#
21.nDucts?-in'Structure '- 1 j l! .1 ' 170: Underground Hydro
• , 22.,,Ducts„Ventilating. r ; i ; I 1 : '71. Product Piping 0Gas 0Oil ,
_23. Gas Pipe-Rough&Test' I I- ' -' ; T IT 1- -72. Underground Flush •
•
.. -'24., Roof Framing I i - ! �i • -- I i e - ' ;73: Undergrnd.Storage,Tank 0 Gas 0 011 _
-44
'‘ 25: Roof Sheathing j '- i . , - F ;74. Overhead Hydro
s. 26. T Bar Ceiling•(Structural),& Monocoat _ ,i 75. Dry Chemical -
27. Frame and'Flashing • I4 i' 1t. i � 176. Dry Standpipe '
' 28.E Lathing & Siding ' _- • I : ' 4I I 177; FIXED SYSTEM FINAL
29.' Insulation . . 1 T 1 : l , i ; - i 1 i 78. FIRE PREV. FINAL
,
-:307. . Drywall Nailing 1 . ' , I a , ; I ; • Notes: i ,
-31. plaster Brown Coat I . I I 1 i i I 1 !A-lSlet.7 Or ag - /_- _ _ i_
32.'Electrical Power Meter-Final i I 1 , I
33, Final Electric -._ _ _ . 1_ . . ! -'.- '
34. Final'Heating & Air Conditioning '
-. j
35. Final Gas Pipe-Tett 1- I ^ 1 _ 'g '
36. HoodorCandky . ' I; I I I,. q i ` � ' -
37. Final Factory Fireplace; I ' I Q/�,��.
I r.'
..�7
38. Final Plumbing 1 �643
39. Water,;Service-Final nal 1 �' 1 i - i '
40. Gas Service-1Final , i ' i a ' ! 1 � 1
41. Solar Domestic-Final ; I 1. I I 1 , 1 - '
42. Backflow P,reventei cal1 ' I I
43. Backflow Irrigation -' 1 - "P 1 _ ,
44. Landscape IrrigationSystem ice. - . - .-
45. Sound:Attenuation-,- . Q. ; 1 �I I
46. Handicap Regulationsll i , ! I t ' c - � -
47. FINALSTRUCTURE& BUILDING' N i I • I 1 ' ,'
I • I '
48. Special Requirements Completed i I I 1
" .
49. Electric'Release td Ediso i I i __ _L_ .
50. Gas Release;to Southern California Gas 6 : , - i :
•
51. CERTIFICATE OF OCCUPANCY ,_ j_ '
No, r . ' ;Date ' I . 1 11-1 i ' ' I ;
Lot 68 13983 . • 17x ' ' ` C% A 6 IDE //e�
COSTA MESA BUILDING-SAFETY DEPARTMENT ' F1�VPi�'CE DEPT.
P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE cO�4R PRINT
PRIUNT�-'� 7..,`_''�2'{ 5. BUILDING
ADD EBUILDI66NG Inns -/ -•_"�.` \.
COSTA-MESA. CALIFORNIA For Office Use Only
Investors Marine Inc. RECEIPT NO. F@R IZO.
OWNER
MAIL RECEI D BY DATE RECEIVED DATE ISSUED
ADDRESS 1600B Beach,
W.Coast Highway M� �/I PiiAR 6 1961
CIN Newport Beaoh,Cali£. NO. 6-1655 ADILDING ///J�
ARCHITECT Same TEL. - COSTA MESA. CALIFORNIA
OR ENGINEER NO.
ADDRESS FIRE ZONE
'�/I pJ UJF(�_
ZONE TYPE / GROUP QY /
CONTRACTOR Mesa Verde Builders, Inc. APPROVED
165a Minorca Drive BY DATE
ADDRESS ZONING ,
Costa Mesa Cali£. ZONE n I NO.OF USE OP NEWO . ,--
CITY 1001
.\ I PLANS.. BUILDING pp_4 i
STATE 161269 TEL. Al 9-0395 l d (^�
LI C.NO. NO. LEGALD68CRIPTION r r C (7 Lit et — / LJ7(
SIZE 7/ I x 1141 • I NO. OF SLOGS.°
'T 4
OF LOT NOW ON LOT A.P.NO.
USE OF YARDS EVES
EXISTING BLDG r� APPROVED ALLOWED
SETBACK LINE FROM 501 421. H (CENTER LINE ST.) �]
CENTER OF STREET REAR YARD 51
FRONT '--) —F T. IN.
51
SIDE YARD I LEFT 61 I RIGHT
R.SIDE � FT. IN.
DESCRIPTION OF WORK (n IN.
L.SIDE /J FT.
NEW I X I ALTERATION I II ADDITION I REAR I� FT. ^� IN.
REPAIR I MOVING DEMOLISH ( BYPROVED A _I• DAT63 J"-(Ir
BUILDING NO. OF I6 1i
SIZE 1500 StJ .,ROOMS 6 STORIES 1 /�
EXTERIOR WALT- l Ing (ROOF shake ln�rle I/ /5)p q/
COVERING IX
SS t.ucco COVERING Ea V1 J
USE OF UIL NGp ND OR TOB P R
b@ingDle r y 7-tr imemoe am garageyey„/
Model No. Shu-0 r
A Attached garage 462 Sq.Ft.
I HEREBY ACKNOWLEDGE HAT I HAVE READ THI APP/LICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT TIiB AB VE IS COR ECT IAND A Re yo cowPURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
Gin PLY WITH ALL CO CES AN1 STATE LA /RRGULATI G
BUILDING CoNBTRUCTI /,'f ` VALUATION
SIGNATURE OF, 4 'I.Ay1. /�� ` /1 ��� PERMIT FEE $ 3
PERMITTEE O N
/� n
$ 2 PLAN CHECK $ w'
AUTHORIZED AGE T o
TOTAL FEE $ ✓—� it.
OWNER MODEEN, JOHN W. DATE February 21, 1964
JOB ADDRESS 2828 Serong BUILDING PERMIT NO.2164.3
P GENERAL CONTRACTOR R. M. Wilson VALUE $ 540.00
k AP No. 139-321-11 - LOT TRACT _ FIRE ZONE 3 DESCRIPTION OF WOR%A1Um. Awning
INSPECTIONS Signature DATE GROUP TYPE V ZONE R1
Ste. PERMITS ISSUED
G — SUBCONTRACTOR DATE NUMBER
Water
Rough Corn. Refrig. ❑ Air Cond. ❑ _
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line ❑ House Con. 0 St. Swr. ❑
Sprinkling System
Construction Pole
Underground 0 Power ❑ _
Rough Wiring
Trenches ❑ Forms 0 Steel Reid. ❑
Floor System
Bond Beam 0 Steel Reinforce ❑
Sheathing
Frame and Flashing
Lathing — In.0 Out ❑
Plaster, brown coat
Refrig. ❑ Air Con. 0 Final
fling, Final
. .4mbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final IR 44(t-
OCCUPANCY
Form BU4-6M-3-63—S-H P 21643
el
21643 FEE RECEIVED
FEB 21 lacy+
COSTA MESA BUILDING SAFETY DEPARTMENT FINANCE DEPT.
P.O.BOX 317 COSTA MESA.CALIFORNIA (C;�IT'�y QAF ((;; S,�`TDp �T�.�p
For Applicant to Fill In Completely AF L•ItA71ON* NRMT
TYPE OR PRINT BUILDING
v For Office Use Only
BUILDING 2- n j-r1 t'—O N 7
ADDRESS n h�/f V
RECEIPT NO. R6RIEMI,T NO
COSTA MESA. CALIFORNIA If"
N1/ L/^Y DATE RISSUE v.2
OWNER \I o Yt 0 W • 447 cl C' IBJ ,•BUILDING „z �J 7
MAIL (J/�/y ADDRESS 15 /..6
ADDRESS -V j�J {(/�/ V 7
FIRE
CITY 41 'A NO. �/O IJ ZONE E GROUP) / [/'y/ ; ,.
APARCHITECT g--- / NO BYPROVE DATE/ '2/ �v/
OR ENGINEER
p� `� ZONING ,p�
ADDRESS CV &441 _
'-6 ZONE* i I NO.OP I UBE OF NEW ,p • y
1 O�/�� /j� /�{ Puna ,..).„..1
/ BUILDING (r G
CONTRACTOR ('�1/I,aa^-i�-l-'-� - ...�1/'I I_ P 7�1�� ��(/ /X�
/0 b1O Su W for DESCRIPTION t^ 4/ V / J k • 1( � l
LEGAL
ADDRESS (((/// r(�//��/����� 3 /
CITY `•'1/P"t- A.P.NO. 1 — 01—//
STATE t TEL E/6 �' 90T TO SIDE¢REAR P.OVERHANG EAVE SHALL BE LESS THAN
LIC.NO. 1 SJ Lfto NO.
EAVES
SIZE I NO.OF BLEB'S. ALLOWED (U.B.C.REQUIREMENT)
OF LOT NOW ON LOT
YARDS APPROVED YARDS APPROVED
USE OF MAIN BUILDING ACCESSORY BUILDING
EXISTING BLDG.
(FROM C/L STREET)) /
SETBACK LINE PROM FRONT £6--Qomp4 FT.
CENTER OF STREET REAR YARD
SIDE
1R. ,C5-FT. Fr•
SIDE YARDI LEFT RIQHT /1
DESCRIPTION OF WORK L.SIDE CFI'. 'F Fr.
NEW ALTERATION ADDITION REAR ,{-LT. FT.—
a
DISTANCE BET. BET.MAIN a • ..
REPAIR MOVING DEMOLISH MAIN BLDQH. ACCESS.BLD48.
BUILDING NO.OF VAR.SC DATE
SIZE ROOMS STORIES C.U.P.# APPROVED
EXTERIOR WALL 1 ROOF APPR(�VED /'� /
COVERING COVERING BY /i{ G� . DATE ��'. I��
U9E,��DING/�ND��/WORK TOTE "ERF�MED LLLLL� (�/,t
&!_ V- Sr 1L/'/ L' •
�j SQ.FT. N
N
I HEREBY ACKNOWLE Ste THAT - HAVE READ THIS APPLI!CATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
ANO STATE THAT T OVH i CORRECT AND AGREE COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. O
PLY WITH ALL CI 0 INA • S AND STATE//// LAWS REGULATING VALUATION , c-O m
BUILDSIGN NG CONST UR ///6�� A / / J
SIGNATOR F / /�//rjr�J Jr� /�' PERMIT FEE $ m
PERMITTEE ffffffff
Sf' 'o PLAN CHECK $ _= p
AUTHORIZED AGENT !S
• TOTAL FEE 5 0