HomeMy WebLinkAbout3155 MADEIRA AVE - Building Permits 7
PROUECTADDRESs: '3155 MADEIRA AV ', UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P OhS94 /
OWNER'S NAME: KENNY DONALD J
ADDRESS: 3155 MADEIRA AVE PERMIT NO: P 058947 PLAN CHECK NO: N GOVI : N SUP?: N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: OTH
(714 ) 557-9698
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : . GAS REPIPE (HOUSE SYSTEM) SQ FT:
ADDRESS: UNIT:
• CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /
PERMITTEE: A-1 AFFORDABLE PLUMBING (714 ) 638-0211
ADDRESS: 13331 WILSON ST COMMENTS: NO ' B ' PERMIT INVOLVED
GARDEN GROVE CA 92644 R6*RE*RERFRERF>F**** ** ****+ERE**RE*aE*RE**x***** * **AERP*RE*** +r**********+E***-x*RER6x*>E*> ****
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 full force and effect. SETBACKS
CITyuC.: 03791� STATEuc.:475940 ss: —36
r-- Date: 5J"t/ 5t— Signature:_ MAIN BUILDING
IN REAR: FT IN FRNT: ACCESSORY BUILDING
FRNT; FTFT IN REAR; FT IN
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have cert late 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).
POLICY EXP.DATE: PARKING REQ• PROV: PARCEL: 13913115 ZNE: REF NO:
COMPANY: PLANNING NOTES>
1 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(5700)or less).
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become ZONING APPROVED BY subject to the W ers' pensation Laws of California.
r Date: Y ,f V signature:
NOT CE I/I.afte making this declaration,you should become subje the Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE
Code.you must fortDING comply Iwith e such provisions this permi shah be ending a revoked.cy e
�CONSTRUCTION LENOINO AGENCY: I hereby affirm that there is a Construction l deem agency for the performance of the work for APPLICATION ISSUED BY; , DATE: Zwhich this permsnissued(Section 3097.Civ.C). ************************* ** * * * *************.Tc * * *****
LENDER: ********************************************** *******************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from theContractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 703t.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5$ SMIP/NON—RES
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7D31.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 ,00
as owner of the properly or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ Lstructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 7, 00 20 , 00 0 ,00 27, VO 27 , 00 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 tar sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 27. 00 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
for me purpose of sate). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27. 00
❑ and Professions ctsde: The Contractors'StateLicnseLaw does not apply too owner tfctorsah builds improves thereon
and who contracts forsuch protects with a contraserLalicense pursuant to the Contractors'State License Law) l em aware **********************************************************************ye********
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: B.A P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: PLU 1 GAS RE—PIPE 7. 00 7. 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES
25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions.
Dale: Applicant:
1 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
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property Ior inspe tion urposes.
-----
Date: v Signature: / �� Uht�.11• '.t' .
u. l i,
•
j,_
Driver's L cense r Social Security a: C
1641<6 While—Buildmo:Green—Code Enforcement:Canarv—AooticanC 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 -
-•ti 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 f
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
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 & Test 72. Underground Flush ,
24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas ❑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 • i _ I ' 4 77. FIXED SYSTEM FINAL
29. Insulation ij I 78. FIRE PREY. FINAL
30. Drywall Nailing ( �_ • HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat I 79. FINAL INSPECTION
32. Electrical Power Meter-Final I ( 80. FOOD CERTIFICATE ISSUED
33. Final Electric I / Notes:
34. Final Heating& Air Conditioning- ( I -
I
35. Final Gas Pipe-Test I .
36. Hood or Canopy •
6.
37. Final Factory Fireplace • I
38. Final Plumbing I4 I I t
39. Water Service-Final I I
40. Gas Service-Final �hQJgZ ippJ/
41. Solar Domestic-Final f/" I4��,�
42. Backflow Preventer I ,
43. Backflow Irrigation -• .
44. Landscape Irrigation System - '
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDINGi
48. FINAL PLANNING I. I--
49. Electric Release to Edison I
50. Gas Release to Southern California Gas Co T I 'ik I
51. CERTIFICATE OF OCCUPANCY
No. Date
--..- Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations.
4._C OF COSTA MESA CONSTRUCTION PERMIT PEANUT NO. TRACT NO. LOT NO. UNIT NO13' .
'-.i. Project Atltlress 3155 Madera C M 92626 �.9� '19 yy�� �/2(�� •
Applicant's Mailing Address 126 Commere i a I Way, CM 92621 TYPE OF CONSTRUCTION L I NEW LIt_
ADD 1-yy ALTERATION L I REPAIR
Owner's Name 119^31 d Ker1R Phone 966-2061 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P-4i6 I Zone
y DESCRIPTION OF W1RK/USE OF,BLDG.I nsta I I CLASS :C med i urn
'Address 3155 Madera, C.M. ROX 92627 cedar shakes w/30A liner..' New metal as—needed.. S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT LJ GRADING LJ FOUNDATION LI STRUCTURAL E Front o
Address -
El TENANT III ELECTRICAL :❑ PLUMBING El . Rear MECHANICAL B N
Contractor's Name ''.Crank Bros. Roofing Cine 548-5563 ❑ OTHER •
A
g 126 Commercial l Way, PROJECT DESCRIPTION SQ. FT. 3.-500- OCCUPANCY S1 n l e C Right N
Address(mailing/ CM 92627 g K G
005993 CONSTRUCTION TYPE residential VALUATION$ 7,610.00 S Left R
City License NO. ZONE GRADING CU.YDS. ACRES •
N
LICESED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M
with section 7000) of Dlvitlpn 3 of theBusiness and Professions Code,and
my license is in full forceg�srtp-e`ect- 408677T
S
License Class 11.�039 -� License No.
(J Date 8/8/89 ,Signa�tuie PLUMBING FEES
WORKERS' COMPENSATION, TION Bar Sink Showers
I hereby affirm that I havea'icer to of consent to self-insure ora certificate ELECTRICAL FEES
1 • Workers' Compensation uiance, or a certified copy thereof (Section
00, Lab. C.) • -- - =., 41 _ Backflow Prevents, - Service Sink- Automatic Washer Transformer 0 15-50 KW
I Policy No. 285/224-89?I✓tCompan State Fund Backflow Irrigation Sewer Cap0 50+ KW
_ Construction Pole Sub.
—,Certified copy is herebyifurnished.
.__X&rtifiegygp filetl With tris city B ' in ivi • Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100amps -
Date V/0��� -•P.pplitant �.`
EXEMPTION FROM'WORKERS'CO SATION DECLARATION Clarifiers Solar Collectors Dishwasher - Meter Dover 100 amps
(This section need not be complete a permit is for one hundred ($100) or -
less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel
I certify that in the performan of the work r which this permit is issued, I
shall not 57rploy ny person in any m to become subject to the Drinking Fountains Solar Tank Fan Motors❑0.1 HP ❑1'f.-8
Worker ws of Calif _
Date i9natur Floor Drains Swimming Pool w/Spa F.A.U. p_—
NOTICE: If,after making this declar tnd become subject to the Inc.Solar 09-15 HP 016-15+
Workers' Compensation provisions of Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or is permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AG NCY Gas Service Outlets ' ;Water Closet - Device Boxes Pole Li ht
I hereby affirm that there Is a construction lending agency for the performance9
of the work for which this permit is issued (Section 3097 Civ. C.)
Interceptors Water Heater e Outlets Ran
Lender's Name 9
Lender's Address Kitchen Sink • \Water Service Switches Sign
OWNER BUILDER DECLARATION
•
I hereby affirm that-Tam-exempt from the Contractor's License Law-for the Lavatories Auto-Wash
following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections
county which requires-a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW Trash Compactor .4
any structure, prior to;its issuance, also requires the applicant for such permit
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 - ' -
'herefrom and the basis for the alleged exemption. Any violation of Section
731.5 by any applicant for a permit subjects the applicant to a civil
analty of not more than five hundred dollars($500). 3
0 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $
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's MECHANICAL FEES
License Law 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 - - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0
sale. If, however, the building or Improvement is sold within one year of com- - - -- Canopy Type II 0 Zoning Approved By Date •
I
prove for the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date 11•15/111
�- /�
.prove ownerhe purposefthof sale). oi/!/
❑ I, as of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 0 Date
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 Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMM OF E ES
builds or improves thereon, and who contracts for such projects with a con-
tractor s license pursuant to the contractor's License Law). I am aware that BUILDING PERMIT $ 0 SMTP $ .S3
( ) Exhaust System ❑ Multiple❑ ■ System Repair/Alteration
proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT
i: I am exempt under Section i B.& P-C.for this reason Firep l/Fact.BIC ICBG# Iffil Fire Dampers ISSUANCE S
PLUMBING $ ENERGY P.C. $
Date ="=� r Owner _ % Heating System& Ducting Registers PLAN CHECK 25% $
I hereb certify that I have rea. t ..•ica ion and state that the above ❑0-100,000 BTU ❑100,000BT r ELECTRICAL $ GRADING $ '
information is correct. I agree to co•-.• y with all city and county ordinances ,` -
and state laws relating to ••ildin• onstruction, and hereby authorize repre- ,��_400J ; PLAN CHECK 50% $ MICROFILM $
sentatives of this city:7.; •on the above-mentioned property for Ii KC2',�'"11——a-Cti� - /t/y ��
inspection purposes. / 8/8/89 �— MECHANICAL $ UI L(!
Signature :�/� Data TOTAL FEE $
' Drivers' License •- SS# - Reinspection Fee $15 $ 3 PLAN CHECK 25% $
CMF 0865.46,rev.10/: - White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor ).1. -lb'._I. =a"-/Soy + .,= a -1 -
,'•S'T, .... G,;iip 77;-.- ±!1'29 fl
CONSTRUCTION AND PLANNING POOL& SPA
AI?PROVALS :Permit# Date Inspector APPROVALS Permit# Date Inspector
1• ;T.emporary 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 UF ER Grnil'. ' 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
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. 'Rough Factory Fireplace APPROVALS Permit# _
21. Ducts, in Structure 70. Underground Hydro
22t'Dus, Ventilating 71. Product Piping 0 Gas UOil
23. Ga@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 I ,i-
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning r)•
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service•Final Y
41. Solar Domestic-Final
42. Backflow Preventer
i
43. Backflow Irrigation
44; Landscaple Irrigation System 14r'
1 ' p
45. Sound' Attenuation �Tr_.-LB-_.: tlOitg
46. Handicap Regulations rIa =`�
47. FINAL STRUCTURE & BUILDING /J4 �� L�218 I
�l flfd `�
7
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date • 1''
• a
OWNER SYCAMORE LAND CO DATE 6-29-59 —
JOB ADDRESS 3155 Madeira Ave. BUILDING PERMIT NO. 9763 _
GENERAL CONTRACTOR Malgren Const. VALUE $ 16,9146
AP. No. LOT 55 TRACT 33 63 FIRE ZONE DESCRIPTION OF WORK res att gar
I' ECTIONS L(I/ DATE I GROUP T p, .1 TYPE v ZONE R1
L..,.arground Soi1J1yTU.G. Water��, SUBCONTRACTOR PERMITS ISSUED
Underground Gas 4-(,� _ DATE NUMBER
Overhead Water and Gas
Rough Heating IN-/Qif �o�-,, 1 sea r _czG/o o,'�
Rough Plumbing Iti_, . ' , ',4creaJ /S-S— / `_t y a_.
Miscellaneous " St
6
Prop. Swr. LintHouse Con. . S G C „ 71 r V•/E (
Sprinkling System //�_
Heatibxt _ Q
Plumbing Fixtures �/ Lf/
Final Gas Test /A•J,/. w 9.. ti'';.4
Construction Pole
Underground Power �y - -��__ _ _
Rough Wiring //?n a 2'4c+ //C!•�Y/CT .Wilt. 02 1 /a 0 4 S
Trenches�l�n,J-Forms, �, Steel y 7—"6- 5-1
Floor System �! � f-5----57
Steel Reinforce Chimney Re-RO
Bond Beam .
S'---thing g_LI:
I e and Flashingi i Aion-7- 4
Lathing, In/Z9i Out , A#69 /0--'2)=-5-1/Plaster, brown coat ii/d //-1-1"-fY
Plumbing Fixtures, Final j--tile- V.2 -inn
Electric Fixtures, Final -s. n , .
Building, Final 'wt. t'Y i ",-
.,
OCCUPANCY I
Form 410-3M-4-59
t ( .' C1rr�ryyCC
9d6u e: . _
J - - JJ WD:
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 317 COSTA MESA,CALIFORNIAI1 1IM1I• \;G DEPT.
FOR APPLICANT TO FILL IN COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
c-3/53.- /Y4tr/t^ */t.
COSTAMESA, CALIFORNIA
FOR OFFICE USE ONLY
I
OWNER Sycamore Land. Co. I RECEIPT NO. I ,PERMIT NQ,
MAIL 10835 Santa Monica nB1Vd.• REC�EIVF/y BY ) DATE RECEIVED /DATE
-IISSSSS�UEED�y
ADDRESS TEW /L• --g7 (!J'_o /'�J `
LOS Angeles r23287 BUILDING
/
CITY NO. ADDRESS
ARCHITECT LIC. COSTA MESA, CALIFORNIA
OR NEER 1,,C• Major NO.
• ESs3.1015 S . Paramount Blvd. ZONE Y ¢—�`
Malgren Const.sTAT153335 APPROVED
CONTRACTOR LIC.NO. BY DATE
ADDRESS 1021S Santa Moni ra Blvd ZONING
LEGAL LOT ZONE IC/ IPLANS ` IUUIOFNEW �^
DESCRIPTION NO. 85 BLOCK TRACT336' (//ems PLANS////��L BUILDWG A.
APPROVED / /�1I♦1
A.P.NO. By DATE to// //u
SIZE i NO.OF BLOCS. YARDS EVES
OF LOT 99 41 X 69 45 NOW ON LOT Q _ REQUIRED ALLOWED
USE OF (CENTER LINE ST.)y/ }�
EXISTING BLDG. FRONT \ 0 FT. IN.
SETBACK LINE FROM
CENTER OF STREET 50 REAR YARD2E1 R.SIDE tt5' FT. IN.
SIDE YARD I LEFT 5 I RIGHT 5 L.SIDE J� FT. IN.
DESCRIPTION OF' WORK -
REAR " FT. IN.
NEI I X II ALTERATION I II ADDITION I
REPAIR I1IMOVING I II DEMOLISH
BUILDING 1693 NO.OF 6 1
SIZE ROOMS STORIES
EXTERIOR WALL I ROOF
COVERING stucco COVERING wood. c}��nse
USE OF BUILDING ARD WORK TO BE'PERF MES••-
Dwelling new construction
lA Att. Gar.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM-
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTRUC _ /^ - VALUATION
SIGNATURE • /y/ PERMIT FEE $ 3 4
PERMITTEE / -- �� - - J fr.---r2 21:. /
�/O PLAN CHECK $ /C(%
AUTHORIZED AGENT �jQ�' $/�/ TOTAL FEE S ,5*".--/
OWNER 'LENTZ, WALTER RUG 1 0 1961
DATE 7-28-60
JOB ADDRESS .315 Madeira Dr, BUILDING PERMIT NO. 12618
GENERAL CONTBACTOR Champion Fence Co, VALUE $ 105,00
AP. No.lij–j00-15 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Block Wall
INSPECTIONS DATE I GROUP I TYPE ZONE R1
rground Soil U.G. Water PERMITS ISSUED
L.._erground Gas — — SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating , IMO,I
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr. Yt��
Sprinkling System C
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
., Trenches✓ Forms L. _ Steel , 536— J, — (c o
Floor System
Steel Reinforce Chimney Re-Rod
Bond Beam
a Sheathing
Nt.nyie and Flashing
In Out
Phister, brown coat _
Plumbing Final
Electric Fixtures, Finl n
Building, Final IY - 7il!v:- 4.4ArAsi a w1r
A
OCCUPANCY - I r
Form 210-5M-11-59 5-B P 12618
12618
` E fid;= '
�' JUL L. IV,
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT.
P. O. BOX SI7 COSTA MESA. CALIFORNIA CITY OF COSTA P.9ESq
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT
BUILDING ii cc {��!'�/� iX� BUILDING
ADDRESS 41.//q
COSTA/ / MESA./ dALIFORNIA For Office Use Only
OWNER k /?/. an / g/J� I RECEIPT NO. /PERMIT Nq�
AMAIL DDRESS Smil/47e // RBC ED ev q�TE Re-Y- d ^•L IC/�A /DG
CITY NO.", ( on BUILDING
ADDRESS
ARCHITECT TEL.
OR (NEER NO. COSTA MESA. CALIFORNIA
ADDRESS FIRE
'Q / ZONE TYPE GROUP
•
BY
CONTRACTOR CC 419/1 /V1/ f vc/-- APPROVED DATE
ADDRESS /etc/ .s /9,771,-7,c/00n ZONING
Sf9/+'T A7/e /f• IONe' ( I PO. I USEOF NEW
('.-ITY PLANS BUILDING
STATE ,/ TEL. ) r 'S
7
LIC.NO. t 7 (/ LEGAL NO.
DESCRIPTION r�
SIZE
NO. OE
OF LOT INC. BLOCS.NOw ON OTA.P.NO. ��'- I'����
USE OF 0- YARDS EVES
EXISTING BLD / A __ _ APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.)
CENTER OF STREET REAR YARD FRONT TFT. IN.
SIDE YARD I LEFT I RIGHT R.SIDE YY FT. IN.
DESCRIPTION OF WORK L.SIDE FT. `JIN.
NE' I II ALTERATION I II ADDITION I REAR —
r ' FT. IN.
//�77
REPAIR I II MOVING I II DEMOLISH I BYPROVELi/ y I . DATE 7-.)-y--((/
BUILDING NO. OF 66 L (./•
�q
SIZE ROOMS STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
. USE OF BUILDING AND WORK TO BE PERFORMED
•
/3/ck I- c . 0
, ; 6'XseXXs7/L'
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND TE LAWS REGULATING
BUILDING CONSTRU TIIOOjIJ VALUATION —
SIGNATURE OP / `,�� PERMIT FEE $ N
PERMITTEP U
S /X
PLAN CHECK $
AUTHORIZED AGENT 2 .— C
TOTAL FEE - 0