HomeMy WebLinkAbout1821 VIOLA PL - Building Permits 4494Sig '- 9 • CITY OF COSTA MESA -
BUILDING DIVISION
> %1 m,r ` DEVELOPMENT SERVICES DEPARTMENT P RMIT NUMBER
1. 1 �le .. l4. PERMIT
+y,_ P02-00738 i
-",,,omrtm.`e
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 1821 VIOLA PL Status: ISSUED
Suite No Applied: 12/12/2002
Issued: 12/12/2002
Vicinity: GARAGE/WORKSHOP
Parcel Nunmber: 42424117 - _ ISSUED BY:
Applicant: UROUIDEZ, ADAM,="' ,- ,
Address: 678 CENTER ST'.,
'I" _ Phone: 949-722-6211 • ! , r
�'-
COSTA MESA,CAS Zip: 92627 _ /r ,-"�
Owner /SUTTON, JEFF AND-PINA, ROSEMARIE '
� ;
Address .1821 VIOLA PL v--v - ;.vA
- Phone: 949-498-4339 v
.
COSTA-MESA,CA Zip, 92627-2725 -c\
y v ,AiA
Contractor : _-•
/ s, fir-
Address: ' '-' ,. �,.i , , A.'
r _ -Phone:
�;
' Zip;
- License: c- \ L,
Arch / Eng:L - l
Li v; ! '- - r ' � ` � �
• Address: , \,.., .. ,.,. . .1 -
' ,, Phone: Al'
i
,
• - - - License - - -
SCOPE OF PERMIT.;;
REMOVE WALLAT OFFICE, REMOVE GAS FURNACE AND CAP GAS LINE, REMOVE KITCHEN AREA-FROM'
"\ EXISTING WORKSHOP. , ;� t
OKTO LEGALIZE WALL BETWEEN BATHROOM:AND NEW WATER HEATER(PER PLANNING) ,/
PLUMBING TO INCLUDE: NEW WATER HEATER`AND GAS,LINE EXTENSION. / /
`, GARAGE/WORKSHOP AREA MAY,NOT:BE CONVERTEDINTO,A UNIT PER PLANNING.PROPERTY
\� - ZONING/SIZE WILL NOT ACCOMMODATE MORE THAN THREE'UNITS PER.WENDY:11/ _
�, ////./ l,_ ._ FEE SUMMARY,. 7/7,-,N ,
�� ;AMT DTY = AMT QTY "/1 �'i/ /,v AMT QTY
ISSUE FEE 'y\$23 50; -- Laundry Tu,b/Washer - $0.00 _ 0 - ; Sump Pum "
Pump / ,/" 7/ $0.00 0
Backflow irrigation
� .$
r� 0.00,,V. 0 - , Landscape Irrigation ' $0.00 0 c,--\Swimming Pool ! $0.00 0
Backflow Preventer '; $0:00 0 P-Trap $0.00 0 ,, Trap Primer,- i/ $0.00 0
Bathtub x$0.00 i - 0- / PressureRegulator --$0.00 - 0i '+,( -Urinal- 2,i $0.00 0
Clarifier System $0.00, 0. . Process Piping(per 10 ft) $0.00 0 Vacuum"Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors . $0.00 0 "=Vac
. -Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0' - Septic Tank $0.00 0 T.,-C' • "--Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo - $0.00,'-. 0' `" Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect " ' -' '$0.00 —'0- Waste and Vent System $0.00 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)754-5626
2446-46(6/00)
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 will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued.
My workers'comp atlo nsurance car' pr9policy number are: •I//��
artier. / Policy Number: ,y�
- a432
(This section need not be corn d fi the prmit is valued at one hundred dollars($100)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 subject to the workers'
• compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 370 of the La or Code,I shall forthwith
comply with these provisions. V /� '1^
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL IES AND IL FINES UP TO ONE HUNDRED
THOUSAND Dot I ARE($100.000):IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
force and effect.Lic.p Class N
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI 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 drivers license. 0 Yes 0 No Driver's 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,falsework,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? 0 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? 0 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 a permit 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 PI 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? 0 Yes ❑No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 II 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? 0 Yes 0 No
8 (If yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: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 Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND 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 with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
alure Of I Owners)
An.ie r Authorized '.•r.scant / Date
L
CODE f INSPFCTION TYPE PAIS MALI ;VDU INSPECTIONTYPt RAM EMBLE
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing 3—N'.0 3 'gin1
200 Final Re-Root 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
nt CITY OF COSTA MESA
BUILDING DIVISION
IDEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
B02-02017
44.1:40.0 .
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesaDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1821 VIOLA PL Status: ISSUED
Suite: Applied: 12/12/2002
Vicinity: GARAGE/WORKSHOP Issued: 12/12/2002
Parcel Number 42424117 Zoning: '
Applicant: URQUIDEZ, ADAM
- ISSUED BY:
Address: 678 CENTER ST ._ — - ,_ ' -
-. Phone: 949-722-6211
COSTA MESA,CA I Zip: 92627 /
Owner: BUTTON,.JEFF AND"PINA, ROSEMARIE /� : '- 2 H-'
Address ,1821 VIOLA PL _ -
//i COSTA MESA,CA Zip: 92627-2725 "1 �-- ( ., -- / �\-\
-\;
i; /. �: /
Contractor:
/Address: ..,/,.; = /
,
�; Phone:
'
• License: -
'Arch , - - Eng:
Address: - - , " - Address:- ., . .
�- Phone: -N - :, ,, , Phone: .- `-
r
-
`.Zip: "" / , License: - v ' -;License; w •
,.+ •_
SCOPE OF PERMIT - " J, . r"
REMOVE WALLAT OFFICE,REMOVE GAS FURNACE AND CAP GAS LINE,+REMOVE KITCHEN AREA FROM EXISTING WORKSHOP. + Y,
' \ OK TO LEE WA L BETWEEN BA3 OM AND NEW WATER HEATER(PER PLANNING) -\ -,
`.GARAGE/WORKSHOP AREA MAY NOT B CONVERTED INTO A UNIT PER PLANNING:PROPERTY ZONING/SIZE WILL NOT-ACCOMMODATE
' MORE THAN THREE UNITS PER WENDY.- ,*.. ,,
..'2 ^
,�" - l ,l
FEE•SUMMARY ,/ ` - /,' . - ,y'
' Plan Check: $15.28 Calc Valuation: - "$50o.o0
Permit: $23.50 -_ - Claim Valuation: ; $500.00
SMIP Res: ' .,$0.50
SMIP Com:, ' $0.00
v.AOther: ., $0:00 ''• ?'' /
,
Inspection: $0.00-. • - •%
/ „ /
Total:, ,$73S.28, -_ ,,: v / r
PLANNING &ZONING—"
SETBACKS
MAIN STRUCTURE Front 07.0- ,, Rear 0-0 - ' Left - 0-0 , Right 0 0 moi'
ACCESSORY Front 0-0 Rear 0-0 -+ ".,1+, Left , -0-0 -;,Right ,- 0-0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutesand-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)754-5626
244646(6/00)
DECLARATIONS tJ ,)
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 will maintain workers'corppensat on insurance,as required by section 3700 of the Labor Cade,for the performance of the werk for which this permit is iss
My workers'compens ion nsurance carder alld policy number are: 1 I m r
Carder: Policy Number: LE.)
is section need not be mp d i he p 1,is valued et one hundred dollars($100)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 subject to the workers'
compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 37 of the r Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL ES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND rrx I ARE($100,000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
force and effect.Lic.# Class e
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ 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 drivers license. 0 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,falsework,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 ❑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 ❑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 en 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 a ermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No
(Section 65850.2 of the California Govemment Code requires that the requested information be fumished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 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 ❑No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: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 Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND 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 with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.
.IIIaagree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
•
�--,rt gn u �gllf'L•"er(s) Carl)
/ \ /�/.. Jo ata
`'I An Or hodze/d Appli .- `art) Date
IfISPECTIOM,'PE WE mama CODE1 7
CODE I
185PECTtON TYPE BATE IIO
1618 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 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/Occupancy03
•
DECLARATION OF AUTHORITY Bldg. Permit# tot - Ott Irk
y FOR AGENTS OF PROPERTY OWNER u U2 ' 27;
TO APPLY FOR PERMITS , This Permit#
Street Address: (32-f Vie /4 ?,1a-o'- AP Number:
1. I (we),,cieir 8 k. d$G Qrr e elk-e+ , declare that I am the Owner of Title of the above
referenced real property, and that I (we) hereby authorize:
Name:04,v1 r\/Acc (l c cAQ Z Telephone Number: 9 Y9) 7 Z z Z_.
Street
Address: 6 7 a COn)I?� S/ C-
City: ( n S t' ✓✓ ? S ACa State: (14 Zip: 92 6 Z 7
to obtain permits in my behalf,as owner/builder,for
at the,above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I (we) shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa, as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
Executed this day of 20 , at , California.
J f fr /6 n /l o �/%1 ,/lo .
Print Name: k sQ✓i C ('r
Signature: sat 6- a / _as ,t / a
)(Date: I Z - G - O Z / 2/��b�
I `
Note: This authorization does not grant authorization to perform the work as owner,
it solely provides for limited power of attomey to secure this permit in any behalf.
0779-46(rev.11/00)
•
November 29, 2002
To Whom It May Concern:
I give Adam Urquidez access to information necessary for building permits at 1821 Viola Place,
Cost Mesa, California.
Thank you,
lab
41to, I 6...eV/L.--
Rosemarie Pina
ADDRESS OF BUILDING: 1821 VIOLA PL DMT: CITY OF COSTA MESA - BUILDING PERMIT
MINER'S ME IF KNOWN: SQUIRE, ALMA S J/PERM NO: P 079978
ADDRESS: 1821 VIOLA PL
' COSTA MESA CA 92627 ' PERMIT NO: P 079978 PLAN CHECK NO: N GOVT: N SUPP: N
714 ) 548-4`120 1 ` P PURPOSE;
APDL.MAILING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU OTH
ARCHITECT OR ENGINEER: LIG NO.: JOB DESCRIPTION : REPLACE WATER HEATER SQ FT:
ARCH.CR ENG.'S ADDRESS: UHT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
commutes NAME: CLEAVINGER, MICHAEL R ( 714 ) 565-4525 ,
CQORACTORSMAUNG 2085 PLACENTIA AV COMMENTS: X
ADORES$: COSTA MESA CA utHO.: 594924 -+ *******x**RE*************x -**RE*******x*N***K- - -*x-*******-x** -**************Rt****
92627 am 44 Z ON ING R EQU IR EMEN TS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under peneiy of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Lenin 3 d the Business and Professions Code.and my license is in full lace and effect.
CITY Lt.NO.: 0 206 uc.cuss: C 36 uua 5949E P • 2 96 MAIN BUILDING ACCESSORY BUILDING
C1(4)
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
I� �!7 9(� Contractor: �7[ LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
BUILDER DECLARATION:I hereby affirm under peneiy d Wry that I am from the Contractors License Law for the
• ••reason(Section7031.5 Business and Professions Code:Any ay county which requires a permit to construct,ether,improve, PARKING REQ: PROV: PARCEL: 42424117 ZNE: REF NO:
oleh,or repair any structure,prig to Os issuance.also requires the applicant for such permit to file a signed statement tat he or she
licensed pursuant to the prar®one a the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES>
Business end Professions Code]or that he or she ie exempt therefrom end the basis la the alleged exemption.My violation of Section > '
7031.5 by any applicant fore permit sublsas the applicant to a tri penally of not more than fore hundred dawn l5500D. **********************************************•*********************************
❑ I.as owner of the poperly or my employees with wages as their sole compensation.will do the work.and the structure is not Wended DEVEL OP MEN T S ER V IC ES-';'' REQUIREMENT S
or offered for Sale(Senn 7044,Businessand Professions Code:The Contractors License Law does nes apply to en Owner of proper +„
who builds or improves thereon.end who does such work himself or herself or through he or her own employees,provided that such
a
improemdsaenotimended adlaedforsal.If.however,the building ZONING APPROVED BY I Lc DATE:
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,as owner of the proper.em exdueively contracting with licensed contractors to construct the project(Section 7044,Business and
Professions Code:The CaNredot license Lew does riot apply to all Owner of Onproperty who builds or improves thereon and who BUILDING APPROVED BY : DATE
contracts for such projects with a comractor(s)licensed pursuant to the Contractors License Law). e
❑ I am exempt under Section: B.AP.C.,l«this reason: APPLICATION ISSUED BY: DATE: lV.
***************************************** * it******************. . •. . .. . . . . **
Dae: Owner: LEGALIZATION : N F E E SUMMKRY STRUCTURAL SEGMENT: N
I do hereby certify that I am aware of and understand the requirements of Celfom'Health and Safety Code Sections 25505.25533.and
25534,and Diol I or any future building ocapat will/will not(circle one)need to comply will said stale codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
e permk forconstrocfwn or modification from Quaky Management District Residential caatngion appfmtiorsere exempt Imm these
Provisions. PERMIT 11,5% ---
00
Dale: Applicant: 2 5% SMIP/NON-RES
PLAN c� •
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedaaiom: ISSUE FEE 22 . 00 y'
❑ I hay,and WI maintain a certificate of consent to seffinsure for workers'compensation,as provided for by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code.la the pudormacadtha work for whop this permit lsissued. TOTALS----> 11 . 00 22 . 00 , 0 . 00 33 . 00 33 . 00 . 00
fl I have and bel maintain waken'compensation insurance,n required by Section 3700 of the Labor Code.for the performance of the
work for viten this permit is issued.My woken'compensation insurance carrier and policy number are:
• Tatler: STATE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 33 .00 OVER/SHORT: .00
prof Number046-96UNIT3278 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed'the perm'is for one hundred dollar/Stool or less.) 33 . 00 - .
❑ I amity that in the performance of the work for which this permit is issued,I shall not employ any person in any marc iso as to tiT
^•• - abject to the workers'compensation laws of California,and agree that i com
I ahou bee aubjed tot **********************************{E.*1E*********************************-)E****k--***
•• •;nation provis• a of Sea'• 3700 d the Labor Code,I shall l 'h comply with
i � __ INDIVIDUA -I F E E BREAKDOWN
.ore: ! ApplicantJr//'rm ) �,
••ng:FeNun to secure waken'compensation coverage/a utile I,and shall sub an employer a criminal penalties and TYPE QTY D E S C R I P T I -O N UNIT COST TOTAL COST
civil fines u to one hundred thousand dollars(3104000),In addition to the cost of compensation,damages as provided by In (fl
Section37osoymelaiorcoea lntanacand arcomay'aless.
wPLU 1 WATER HEATER AND/OR. VENT 11 . 00 11 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there e a construction ending agency for the 'END OF FEES
performance d the work for which this perm) (Sectionis issued 3057.Civ.C). '
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read the and d gate that the above information is correct,I spree to comply with at city and county ordinances n
and sore laws relating to building construction end hereby authorize representatives of this city to enter upon the above-mentioned properly
for inspection purposes ' 01 DATE? 10//1S/95217161 TIME: 13:44 T 33.00
JENNIFER KELDER
ir
.111001IP !. or4_14. /1 Date: /O /
/
Signature of e � /ay pelican � - -
(5151da.WP) White-Building&Safety:Green-File:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
�L° - PO x SPA - '
CONSTRUCTION AND PLANNING .
<„'yr - - -
APPROVALS Permit #. Date Inspector , APPROVALS Permit # Date Inspectors
. 1. Temporary Electrical Service or Pole _ 52. Pool & Equipment Location 1
2. Soil Pipe-Undrgrnd. .-- ' 53. Steel Reinforcement - ' . w
3. Electrical Conduit Utility-Undrgrntl. 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-GI-}NITS '
7. Footings - 58. Electrical Conduit-Undrgrnd. .
8. Foundation • 59. Gas Pipe, 0 Undrgrnd.,Test . 1
9. Water Pipe-Undrgrnd. - '60. Backwash Lines, P-Trap, 0 llpdrgrnd. '
10. Structural Floor System . 61. APPROVAL TO DECK = I -- r
11. Property Sewer Line & House-Connection -62. Backwash & Receptor-Final r '
12. Sewer Cap - i ; 63. Heater & Vent-Final I
13. Roof Drains .64. Plumbing System - Final -4
14. Rough Plumbing 65. Electrical-Final `j
15. Rough Electrical-Conduit . 66. Solar System-Final
16. Rough Electric Wiring , •- - 67. Fencing & Access Approval , • 1
' 17. Rough Wiring Sign - ' .68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling ' 69. POOL/SPA SYSTEMS ANAL
19. Rough Heating & Air Conditioning T - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - . . ., , APPROVALS, Permit# -.
21. Ducts, in Structure . , - 70.. Underground Hydro
22. Ducts, Ventilating. T. . : • 71. Product Piping OGas 0 Oil
•
23. Gas Pipe-Rough & Test - - 72. Underground Flush '
24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil
•
25. Roof Sheathing . t
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
32. Electrical-PowerMeter-Final • 80. FOOD CERTIFICATE ISSUED •
33. Final ElectricNotes'•
34. Final Heating& Air Conditioning i0/v04cica ]'�Q Cem.r„y-
35. Final Gas Pipe-Test _ �
36. Hood or Canopy - - -�} -, .. .
37. Final Factory Fireplace _ --
^
38. Final Plumbing - 10-16-'4, Rw
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer - -
•
43. Backflow Irrigation .
44. Landscape Irrigation System - ,
45. Sound Attenuation -
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING 1
48. FINAL PLANNING - _
1 .
•
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -- -
51. CERTIFICATE OF OCCUPANCY
No. Date
•Applicant to fill in all spaces within heavy border lines and si• 1 appropriate declarations. .
CITY OF COSTA MESA PERMIT NO. TRACT NO, t,1,-NO. BLDG.NO. " - - - • . ' - - - -_
CONSTRUCTION PERMIT
Project Address QA I V it A' -PL ' TYPE OF CONSTRUCTION' _ _ ,
•
Owner -..9'CA I �L c...„ - ' - Phone O NEW O ADD 0 ALTERATION " ' . ' . . . /879 14/-27/83 - 5e3(}•• TL
Address- SAy,-ice -As A aaVt'c , ` - -' - O REPAIR 1 O CONVERSION-0 DEMOLISH _
ZONIN TNS -. '
Arch/Eng, - License No. . - O OTHER
Address ' - - '� -- " - ' . . - ., DESCRIPTION OF WORK _ - _ .-_ A'P.# -
ZONE , PLNG. REF.
Contractor�hA GI�7 C� '�L)st AMUS Phone.S92' /,3 TYPE OF PERMIT t_ � • - BUILDING t
CCC)11 _ _ SETBACK C/LST. Pfd OPE RTY LINE
Address �Z DJ "O 44 A _S G -, -0 GRADING"; FO FOUNDATION - STRUCTURAL SIDE
'LICENSED-CONTRACTOR DECLARATION - O TENANT O ELECTRICAL LUMBING' OMECHANICA SIDE YARD - - • ' ""
I hereby affirm that I am licensed under provisions of Charter 9 (con, RIGHT
mencingofessi -with section 7000) of- Division.-3 of the' Business and ❑ OTHER - - - - --- - -Professions Code,Code, and my license is In full force and effect.. REAR YARD(TO P/L) .
--- - - - - 3189 PROJECT DESCRIPTION
License Class Lk se Iy�n� PKG.SPACE REQ. PROVIDED '
Date'1 -An3 Signature oT.4 ITti t A �- . SQ:.FT. -. _
`S��{/'j r STREET WIDTH PARK FEE$
WORKERS'COMPENSATIONthatIhaveaDECLARATION'. - "- OCCUPANCV_CONST RUCTION TYPE -' -
-I hereby affirm that I have a certificate of consent to self Insure'or.a :VALUATION - ' ZONE • ZONING APPROVED BY I DATE
thereof SectionO3800,b ab.C.)•certificate-of Workers' Compensation Insurance; or a certified copy GRADING CU.YDS. ACRES SPECIAL CONDITIONS: - . , . -. ..
(No. off ''/7 / 7 - - :. -
Certified'copY is hereby turnishetl. -- - - - ''t` REMARKS: '` _ -
• ertlfied copy is filed with the'city Building Division. ;I,, p- •
EXEMPTION FROM WORKERS' COMPENSATION'DECLARATION - - , ' ' - _ " ' - -
(This section need•not be-completed if-the permit is for one hundred .
- , - ._-
--- -- . . . . "_ ._ ,_ " __ _ ,.._ _ ,
($100) or less).
. .
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 ,'PLUMBING -- ' , , PLAN CHECK - 'ELECTRICAL` - -PLAN CHECK , „ '
subject to the Workers'Compensation-Laws of-California:. -..- - - _. - Ow ELCfIVL� GARAbE.
Date - Signature' BATHTUBS SHOWERS A , e
NOTICE: If after making this declaration, you should become,subject TOILETS', -, i- L . URI •L'I - • GENERATOR 0-1 KW-1.10 KW.
to the Workers' Compensation provisions of the Labor Code,you must _ _ TRANSFORMER -,
forthwith comply with such provisions or this permit shall be deemed LAVATORIES D Ui:LE S 'APPLIANCE 10=50 KW i. -__50.-1- KW- `
revoked. _. - - . . _
CONSTRUCTION LENDING AGENCY KIT.SINKS KERS ' ' MOTORS- - 0=1 HP=1 30 HP
I hereby affirm that there is a construction lending agency for the per- SERV ICE SINUMPS'• - -(INC.-SOLAR) ---'10-50 HP_" 50+ HP-
formance of,the work for_which this permit is issued (Section 3097 I _ _
CIv. C.). FLOOR SIN S FLOOR DRAINS- FIXTURES- -- OUTLETS SWITCHES
Lender's Name _ _ _ _
Lender's Address DRINKING OUN ANS a GAS TUBE SIGNS ' ' - .
OWNER BUILDER DECLARATION - - - INTERCEPT CLARIFIERS POLE LIGHTS' -
I hereby affirm that I am exempt from.the Contractor's License Law for - -
'the following reason (Section 7031.5'Businessantl-Professions Code:-
Any_city
ode:Any_city or county which requires a permit to construct, alter, - POLES METERED SUB .
improve,demolish or repair any structure, prior to its issuance;also re- WATER SERVICE i ALTERATION-- ' _ -.. -PANELS MAIN SUB .
•
quires the applicant for such permit to file a signed statement that he _ _
is licensed pursuant to the provisions of the Contractor's License Law' GAS SERVICE OVTLETS SERVICE ' - AMP
(Chapter 9" (commencing with_ Section 7000) of Division 3 of the _
Business and Professions Code) or that he-is exempt therefrom and the WATER HEATERS_ •i.BTU OUTPUT -' ' - . .
sis for the alleged,exemption. Any violation of Section 7031.5 by _ ___ _ _ -- __ -' �-
_
applicant-for a permit subjects the applicant't6 a civil-penalty SEWER CONNECTIONS-"- .. - ' • -- -' " ,. - .. -
not more than five hundred dollars ($500). _ __ -
■ I, as owner of the property, or my employees with wages as their SOLAR TANK - -" COLLECTORS ��
-
sole compensation, will do-the work,and the structure.is.not.intended - -. ..
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ®� _-...ISSUE
Contractor's License-Law does-not apply to an owner of a property - . . _.. . _ e .- r _
who builds or improves thereon, and who does such work himself or ISSUE FEE ' APPLICATIONAPPROVED BY ;DATE- 02i •
-through-his own employees,-provided.that such improvements are not. - _ _
intended or offered for sale- If, however, the building or Improvement MECHANICAL PLAN CHECKiiiii SUMMARY OF,FEES
is.sold within-one year-of completion, the.owner will.have The burden_ _. _ -
of proving he did not build or improve for the purpose of sale). BUILDING' .
al; as-owner.-of theHEATING SYSTEM 0-100,000, BTU PERMIT _ $ - SMIP( E
property, am exclusively-contracting with 'AND.DUCTING -
licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK -5_ '� —_ PERMIT. .,
.and-Professionsoperty Tho builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING
tracts from'such projects with•a contractor(s)9lcesnetl'pursuant-to - SVSTEM" -' "' - ` - -" -- - - •- - - - - - - -GRADING $ `
the Contractor's License Law). 100,000 +BTU PLAN CHECK''.$"' ' ('i,, " _
❑ lam exempt under-Section Cis, P.C.for this - - - ' ' '
• ELECTRICAL $ $
BOILERS BTU .. . ' "
'PLAN CHECK_ S
" MICROFILM E-^ •
reason' - - - ,, -
SVSTEM REPAIR,ALTERATION ' MECHANICAL $ "" - -• .=TOTAL FEE,$
._ '
-i hereby.cert ify that I have read this application and.state tha Lthe above. EXHAUST SVSTEM _ MULTIPLE " --LESS AD-' .i i ' +
_
information is correct. I agree-to Comply 'with all city and county ' ' - -- PCAN'CH ECK $ - VANCE PC $•'"' -'` -
ordinances.and state,laws.relating to.construction,and hereby,authorize �V - . . - r M1
representatives" of this city to enter- upon the above mentioned - �s" t s/ -
property,tor ins otio purr odes. 1, - = _ _ . FEE
Drivers'
�Sf7 -/�'l..Q�C�i� Date ��- - 'J.3 ))
FINAL $v'
Drivers' License r 55 . ��
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
+
CONSTRUCTION AND PLANNING ;` POOL&SPA
APPROVALS Permit# Date Inspector APPROVALS . . Permit# Date ,f Inspector-
1. _Temporary Electrical Service or Pole S 43. Pool & Equipment Location - + , ' '�
_ _2. Soil.Pipe-Undrgrn• • • 44. . Steel Reinforcement - - -- ' n - - •
-
3.. Electrical Conduit Utility-Undrgrn _ 45. Forms -- -
4.." Electrical Conduit-Undrgrn, _ _ 46. Electrical Bonding - - -- - - _ --
5. Steel Reinforce• 47. Rough Plumbing & Pressure Test L. . ' •', ' '' '1 ' 7 ' •
6,_ Electrical UFER Grn48. APPROVAL TO COVER-GUNITE, . - ' - -- - -
_7. _Footings 49. Electrical Conduit-Undrgrn , -
. .8.._Foundation _ : - - • : r - - .- 50. „Gas-Pipe; ❑Undrgrn,Test . . • '
9. Water Pipe:Undrgrn ' 51. Backwash Lines,P-Trap. 0 Undrgrn - - - - '
_10. Structural Floor.Systen7_-, , • ' • .. . 52. APPROVAL TO DECK ' :; '
11. Property Sewer-Line & House Connection . 53. Backwash & Receptor-Final . ... .
12. . Street Sewer Connection P °' "•
_ - --- .. . : . . -- . : .- . - _.54. Heater &,Vent Final , ,
. 13. Rough Plumbing , '- - '- "r•- 55. Plumbing System - Final 1 r---' . .' 7., 2't-
14. Rough Electric-Conduit - -- - - - - . 56. - Electrical-Final--
15. Rough'Electric-Wiring ' - '" - '- -- - - - -- ----- - 57. Solar-System-Final • - - '
--16:---Rough-Heating'& Air Conditioning . . . _ - - „ _ _-_ . _ - - .58• .. Fencing &-Access.Approval . • . ..
- 17. Ducts, in Structure` ' 59, APPROVED FOR PLASTERING I' .. ' Jr,
-18..-.Ducts,.Ventilating __ - • t - - ,
19. Gas.Pipe-Rough'&Test ^ ' , . . - _ " . , -:_ ,.60. POOL/SPA SYSTEMS FINAL • - •. . •• -
.20._ Roof:Framing '. ._ �;
21. Roof Sheathing' "-- - -. -
22. FrameandF.lashin NOTES: • ' • • , _
23.._..Insulation: : ' - - - - • '- . . - _ rs_,. •• _ ,,. . 6 - -_ -
- 24..--.Lathing.& Siding ,_ _ __ ' _ _._ _ . . -.. . " ,•,': _- .
25. Drywall Nailing - _ .. -
-. -26. .Plaster Brown Coat - . _" - - - _ _ _- __ .
27. Electrical Powei"Meter-Final ' __ ` •.__ .. ..' " - V `
- - 28.---Final Electric ' . - . . • • . - -
- - - ,.
29._ Final.Heating& r_Conditioning. •
30. Final.Gas Pipe-Test .. ,, • _ .,
, .31.. Final Plumbing __ _ _ . _ __ . .
32.- Water Service-Final .
33.-_ Gas Service-Final .. _ -_ _ -
34. Solar Domestic-Final .
35. Landscape Sprinkling System . -- - + - . . '
•36. --Sound Attenuation . . , - •• "
37. Handicap Regulations . - ) i_,+ .._ . .. . . • . , t e ._ - • - '. .. .-
38. FI NAL STRUCTURE& BUI LDI NG • • - - ' .: .
39. Special Requirements Completed - • - "- ' - -' -- - - `
40. Electric Release. to Edison - . - . . . . - - - - - - - - . - •.
, 41. Gas Release to Southern California Gas Co. ' _ - - -
J
,•.......Z.,•.......Z.42. CERTIFICATE OF OCCUPANCY i _ - :, - s
] No' Date - - - -. . .. _ , „ -
- _ -_.. _. , _ ._- . _ -_ _ . __ . . R <• - +,
f'`r- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate • _ _ __ _ _
9 declarations.
CIkOF COSTA,MESA. •CONSTRUCTION PERMIT - PERMIT NO.,1?. . TRACT NO. LOT NO.. . • UNIT NO, - - n • -
Project Address ' ,, c,2/ ���0�/d i4' - /- /5O 10� ` : • ; Ir _ - • . .: I . '071Q I�/22/B4 „ : 5e,0Uj :T�
r•
.TYPE OF CONSTRUCTION. LJ NEW Li ADD: O ALTERATION '❑ REPAIR
Applicant's Mailing Address , /j 721 2,21d4'4I . / . - _
Owner's Name ��' ' [[/�[T Phone ❑ CONVERSION :❑.DEMOLISH ❑rOTHER -_ A.17.#, - Zone
�� _ - ' DESCRIPTION OF WORK%USE Or BLDG.
Address ' ' / ��LIJ�(/' �- - _ _ . , $.. Main Building: - _ - Accessory Building s •
ry , ,Z
Arch/Eng..- ' ' ' ' • ' • 'License•No. - - ' - - TYPE OF PERMIT. ' ❑GRADING C❑ FOUNDATION,' LJ'STRUCTURAL , . i ,T Front • . , _ - _ I - 1 O 1
Address 1 • - - '' ,> // - ,-I-��p' ,`'_• s ❑ITENANT� ❑ ELECTRICAL CI!PLUMBING ❑ MECHANICAL- ' ' B Rear • • N
'Contractor's Name Cy�f r��M1 Phone vdx �YtO • - ❑ 'OTHER • - - - C Right - - - - I `N
(' -PROJECT DESCRIPTION •• $Q. FT. - - OCCUPANCY ' - G
.Address(mailing) I - Z/ ' -,0/29(7/.'.0 nT I - K--
` � / 3ry v • CONSTRUCTION TYPE 1 - VALUATION$ S: Left , • • ,. _ R,.
City License No. c/ ZONE - GRADING CU.YDS.- • ACRES •
LICENSED CONTRACTOR DECLARATION PSI ng. Ref.# i Parking Req./Provided ' E'
Q,
I hereby affirm that am licensed under provisions of Charter.9 (commencing Remarks: . 1. - " '
Planning Notes: ' .M
'with section.7,000);of Division 3:of the Business and•Professions Code, and ` - - - T
my license is m full for and efffct. •,s /77 • - •
• 1 - - S
License Class ' `/_ R/ 1e G 7 -
/ Date.../0”...:90-17J' Signature -�-�"11.° i i PLUMBING FEES I ' 1
( WORKERS'COMPENSATION DEC ` ' I
Bar Sink' , Showers
• 'hereby affirm that.' have a certificate of consent to salt-Insure ora certificate I ELECTRICAL FEES
4-- "`f Workers'-Compensation Insurance, or a .certified copy thereof (Section.-, _ - - - -
' Backflow Preventer •' `Service Sink , ' 1 7 "
/ j;`7100, Lab.. C'. r-/' - 1 - s I _ Automatic Washer i Transformer 0 15 50 KW ,
`moi "Policy No�rr�67 <' '�y� - Company •�ie�'¢G. S; 1 Backflow Irrigation Sewer I•
- - ❑ 50+ KW
P1 A Certified copy is hereby turn fished, Cap Construction Pole Sub .Lai
fk Certified copy Is fllediwith the city Building D a•• . Bathtubs Sewer Connection i Cooking Unit I - Meter Opp t0 100 amps
•`o Date , t"' J-v-'1/ Applicant -.
EXEMPTION FROM WORKERS'COMP-•• ,r • • C"'CLARATION ' Clarifiers • , Solar Collectors I , I pishwasher .. „___,_"'' Meter ❑over 100 amps '_ . , .•_•,_I
(This section need not be completetl-if the permit is for one hundred ($100) or y Sub Panel'
less). , • ' Dishwasher ' ' Solar Piping , ' Dryers ❑Gas ❑Electric � i
.I certify that in the performance of the+work for which this permit is issued, I - . 4"
shalb not)employ any person in any manner'so as to become subject-to the • Drinking Fountains Solar Tank ' Fan • - i
• Motors❑0-1 HP ❑1'h-8 •
Workers' Compensation Laws of California. I
• Date ' Signature I- • Floor Drains . SwimmingPool w/Spa •' % r- '-
'NOTICE: If,after making this declaration, you should become subject to the _ P F.A.U. Inc.Solar ❑9-15 HP ❑16-15+.
.Workers':Compensation provisions of the..Labor.,Code,.you must-forthwith. Floor Sinks - • ! - - �"'^ - . - - • r'- - - , ---'1 -' -' K' — ;
complywith such. rovisions or this -Urinal , FI%t UreS�' I Microwave` - ! , -1 .�
I I p permit shall; be deemed revoked. _ 1 1
'CONSTRUCTION LENDING AGENCV:y: , '1,' i S_ I Gas Service;. Outlets ' Water Closet . •
;I herebyaffirm that there is a construction lendin a enc for the - �(] Device Boxes Pole Li ht; •
g, g y performance•• '; / 1 9 1
•of the work for which.this. permit is issued .(Section 3097. Civ C) ' - 1
• - Interceptors ' Water Heater; i - , Outlets - i Range
-Lender's •Name - _ -- + .
Lender's Address _ - Kitchen Sink' - - - Water-Service ' - Switches . Sign
OWNER-BUILDER DECLARATION 1 •' 1 • -
I 1 hereby affirm that I am exempt from the Contractor's License Law for the - Lavatories..) - • ; Auto-Wash I I- ' , ' Garbage Disposal - Standing Sections • - )
' following reasonc(Section 7031.5 Business and Professional Code: Any city or,.. ) ' - • u )
' county which�requlres a permitto construct;alter,improve,demolish onrepair P-Trap I ' ' • d ' ' Launar Trays '
- any structure, prior to Its issuance, also requires the applicant for such permit ' - y y Generator ❑0-5 KW ❑5-15 KW Tras)i Compactor
' to file a signed statement that he/she is licensed pursuant to the provisions of • ._ ,
the Contractor's License Law,(Chapter 9(commencing with Section 7000) of - Roof Grains - I •
rlivision '3'oft the Business and•Professions Code) or that,he/she'iexempt ) - - -
arefrom and the basis for the alleged exemption. Any-violation of Section - -
31.5 by. any applicant for a permit subjects the applicant.to, a civil - • -• - - -
natty of not more than fivelh untlred dollars($500). I - -' • I 3 , (
a i, as owner of the -property OrthW einployee5 with-wages as their sole Reinspection Fee • V $15 : C . Issue Fee I $ 1 • -
, compensation; will Ido the work, and"the structure Is not Intended or offered , - Reinspection Fee • ! $15 Issue Fee $ 3
for sale (Section 7044; Business.and,Professional Code: The Contractor's - I • , 1 MECHANICAL I 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 - • 'I - DEVELOPMENT SERVICES REQUIREMENTS: '
•employees, provided that such Improvements are not intended or offered for j . Boller: Hood or Type I '❑ • • • 1
' sale. If, however, the building or improvement is sold within one year of com- l •
• .Canopy Type 11 ❑ 1
:Zoning Approved By I Date
pietion, the owner will have the burden of proving he/she did not build or im- , ' Duct-Under Ground: , - i I )
prove for,the purpose oflsale). t ) , - I Building •Approved By n ; Date
' 0 I,as Owner of the property, am exclusively Contracting with licensed con- , Duct-Structural I I Refrigeration Syste• m --i 1 Application Issued By • •�' I Data .4'—' - )
1 tractors to construct the:project (Section 7044,Business and,Professions Code: . - - 1 - • 1
i The Contractor's License Law does not apply to an owner of property who ' I, Duet-Ventilating -• 4. .. ... _. 00-100,000_BTU 0100,000 BTU SUMMARY OF FEES •
1 builds or Improvesr thereon,and who contracts-for such projects with a'coni - - • , 1 I
I tractor(s) license pursuantto{the Contractor's License•Law). I am aware that •, i BUILDING PERMIT '$ ' SMIP '$ •
' proof ol,'their Worker's Compensation insurance should be provided to me. I_Exhaust System 0 Multiple❑ System Repair/Altera[ior, 1 I PLAN CHECK '$ 1. PERMIT i - 1
❑ I am exempt under Section B:&P.C.for this reason ' Firepi/Fact.Blt. ICBG# Fire'Dampers. 1ISSUANCE $
j PLUMBING I$
cc.:
Date ( Owner ' • - ) Heating System & Ducting . Registers I PLAN CHECK 25% !$ ' ENERGY P.C.
II hereby certify that-i havetread this.epplication and state'that the'above ❑0-100,000 BTU'❑100;000 BTL. • --- - ' - - -' - • - ' GRADING( ,$
information is-correct. Ilagree to comply ith all'city and county ordinances I : 1 : - i ELECTRICAL ,$ _ r j
rand state laws relating to buildi ction, and hereby authorize repre- - - PLAN CHECK 50'/0 '$ MICROFILM $ I '
'sentativez of this city to e he above-mentioned property for - + !
•inspection Purposes. 0:...... ........r
•Signture .�"'i ' Date��?.d"��' MECHANICAL $ TOTAL FEE $ _ 0O
�� Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
•
Drivers' Lice, `- . I _
CMF 0865-46,rev.10/84 White . Building; Canary - Applicant; Pink -Accounting;Goldenrod -Assessor
•
CONSTRUCTION AND PLANNING' .• POO' .PA
'A'� 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. ElectricallConduitjUtility-Undrgrnd. ! - 54. .Forms - - I I•
4. Electrical Conduit-Undrgrnd. - - ' 55. Electrical Bonding -
5. Steel Reinforcement' • ' - 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grnd.d, - " 57. APPROVAL TO COVER-GUNITE ,:;.E:? /I
7. .Footinge '• • I : I;s onrgrn
• 58. Electrical Conduit-Undd. - • rl
8.�Founda{ion.. �? :.�•' -,,•i1 ' -"i? 59, Gas Pipe, 0 Undrgrnd.,-Test- '
`9. Water'Pipe-Undrgnd'. ¢ I ' . ..:;:';,./701 60.• Backwash Lines;P-Trap,.0 Undrgrnd: '
•:o •
10. Structural Floor System •./
10. ^ r;/%v . -61. APPROVAL TO DECK -
11. Property Sewer Line & House.Connection ;• " 62. Backwash & Receptor-Final _ i
12. Sewer Cap .
ii f -,' 63. Heater & Vent-Final • /
13. Roof Drains " - 64. Plumbing System'- Final - ,>
14. Rough Plumbing: 65. Electrical-Final - f
15. Rough Electrical-Conduit • • • " 66: Solar System-Final '
16. Rough Electric Wiring 67. Fencing& Access Approval .3 ,• . ' •
17. Rough Wiring Sign - 68.. APPROVED FOR PLASTERING •
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Healing &'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. Insulation78. FIRE PREV. FINAL .ix . .
30. Drywall Nailing ' . • - 'HEALTH DEPT. REQUIREMENT 1 '
31. Plaster Brown Coat 79. FINAL INSPECTION .
32. Electrical Power Meter-Final • !. - 80._FOOD CERTIFICATE ISSUED '
33. Final Electric - " ' . " . Notes:. • .
34. Final Heating & Air Conditioning. , '
35. Final Gas Pipe-Test - ' : -
i 36. Hood or Canopy S - - - -
37. Final Factory Fireplace • .I - -
38. Final Plumbing -i - , , •
39. Water Service:Final l " - -
40. Gas Service-Final , /v1psy f - • •
41. Solar Domestic-Final I _. �'Y��C- ld�r -- -
42. Backflow Preventer • 1 _ _ ' •
,
43. Backflow Irrigation - ' -
44. Landscape Irrigation System . , - _ _ 4 • , .
45.-Sound Attenuation• ' ... ' , ' • - F
46. Handicap,Regulations ' - - 1 -
47. FINAL STRUCTURE & BUILDING - .
48. Special Requirements Completed 1
,
•
49. Electric Release to Edison ` -__ - -
50. Gas Release to Southern California Gas CO ' r - -
51. CERTIFICATE OF OCCUPANCY • ,- • -.
No. - Date -_ __. • -
}. 18511 • FEE RECEIVED
COSTA MESA BUILDING-SAFETY DEPARTMENT DEC 21]1982-
P. O. BOX 817 COSTA MESA. CALIFORNIA FINANCE DEI- I.
For Applicant to Fill In Completely APPLICATION FOR PERMIT COSTA MESA
TYPE OR PRINT
BUILDING �. - T. BUILDING
ADDRESS / A'MESAOCALIFORNIA,.` /J For Office Use Only
[ /I /•� S 4 C. {� / / .c- I RECEIPT NO. I 1R85)/
� V l
OWNER /^i T85
ADDRESS
Pi */ /2 i1- / (, RECEIVeO BY II/o/a/H (z .Io fg DATE a//j 0Z
CITY (i 0 g 7� i'F S NOOY/9'74 ADDR'yE88i_p`/ 102 // l�//�-�L -0-2/X. V-V'
AR' TCI' TEL. — COSTA MESA. CALIFORNIA
01 NEER NO. .
ADDRESS - FIRE /
{, /p/� ZONE �,�J//��.�T,�YPPE///�4. GROUP -
06PFPICALfiOR /I/ Y• ��- BYPROV�D _ /- " /6' keyATE 4.1 J//h7_
ADDRESS VV `J�� ZONING �f]�./�(,(�..-.
ZONE OF USE OF NEW I/' ' .
CITY _ ' ANS ' BUILDING
STATE �- TEL. LEGAL/ / a �_//
LIC.NO. . NO. DESCRIPTIO i, r!.• // (J
gr
y / NO. OF SLOGS. / / /� , n
OF LOT/�/ A (p 0 NOW ON LOT A.P.NO. I / 6 — (9 ! .-L — 0 tT
USE OF /1 /J 4 y [A /> �� YARDS EVES '
EXISTING BLDG. (�- -�I 4/� C- `//�� APPROVED ALLOWED,WESETBACK �i
CENTER OFINE STREET 1(/1� REAR YARD / "/ FRONT LINE ST.) 17-"FT. // / IN.
SIDE YARD I LEFT I RIGHT R.SIDE 61.- 11. IN.
DESCRIPTION OF WORK
L.SIDE S FT. IN.
NE I /�
• ALTERATION I II ADDITION I REAR / 0 FT. -1 IN.
REPAIR II MOVING I DEMOLISH I APPROVED
BY
' ,. 0 1 DATE / , `-s~
BUILDING//�/y/�7� NO. OF / / I•�'
SIZE �V //�� /.J ROOMS STORIES
EXTERIOR W L dee/
ROOF ,t4' h�s'�S
COVERING ®(YL�� COVERING/, CJ'
USE OF BU .DI G/ND WORIiTO .BCE PERFORMED
(y: /AT t�r. fa e S. p�(J l
W
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHONDHR VALUATION IS POR THE
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FSE ONLY.
-PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION.�/J ,o VALUATION
SIGNATURE O��y, /L � 6U PERMIT FEE $ N.5:
1O
PERMITTEF ��C�I//�„`7/ !!!�//LLLf�/. _ o
/ % �S $ J j PLAN CHECK $
AUTHORIZED AGENT rc
TOTAL FEE $ �� D
4
JOB ADDRESS 1821 Viola Pl. SQt-1 1��'1 - BUILDING PERMIT NO. 18511
GENERAL CONTRACTOR Owner-Bldr. VALUE $ 613.00 / -2../
AP No.116-09208 LOT TRACT FIRE ZONE DESCRIPTION OF WORKA83 Att
- INQPECTIONS Signature DATE I GROUP j TYPE V ZONE R-2PE
Gam - - ISSUED
SUBCONTRACTOR DATE RMI7`SNUMBER
Water
Rough Corn. Refrig. 0 Air Cond. ❑
Rough Heating
Rough Plumbing _
Miscellaneous
Prop.Swr.Line 0 House Con. 0 St.Swr. [(
Sprinkling System
Construction Pole _
Underground 0 Power ❑ _
Rough Wiring `��N /./,/./a �C/���'c�, PP1j !-/b'�v�l 77/6
Trenches ❑ Forms 0 Steel Reinf. [I o
Floor System _ / c ,
Bond Beam ❑ Steel Reinforce 0 n_ "'6
Sheathing ese't ( 17 --43 , C (Ifni- /-
Frame and Flashing �;,�pi / ti 6/43 IA) vV
Lathing — In 0 Out 0 ;rile /-. E+.T3
Plaster, brown coat j
'g. 0 Air Cond. ❑ Final
.ng, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Buildine. Final nn as // -7-.17/E L _,
-- `1 12166 . .
COSTA MESA BUILDING-SAFETY DEPARTMENT FEE RECEIVED
P. O. BOX 977 COSTA MESA. CALIFORNIA
(n 6 (cam
For Applicant to Fill In Completely APPLICATION FO�I DEPT.
TYPE OR PRINT BDI�DI�g OF COSTA MESA
BUILDING J rya/ // a �� f / •
ADDRESS/ COSTA MESA. CALIFORNIA/ ' For Office Use Only
)' �I� �.+y ( RECEIPT NO. pEdtM[Tj .O.^
OWNER /`F 4/k 8 9 (i. /I ) /- -e- 'll...- BL-S
A //f�/ /_/4 � w / 4 RECEI D S LATE KCEIVtv I t%1 E -`
ADDRESS Y �Pf ) ^�(/O / JJ�JJ�JJ�� U
CITY�^ IAAil it S A NO.41 ADD EISS / o(/ //iVfl'L4L/ I22
/ fry is( Y!/
ARC "ECT TEL.
OF NEER (1),L,(1),L, /V .t !2_ NO. $TA MESA. CALIFORNIA
ADDRESS y^�}� FIREgyi
,! /'
CONTRACTOR / /Lv'�j(2-41 / - ZONE (5/1- IIIII79k-TYPE DATE GROUP/ill,I
ADDRESS Y�I ` ONING ,� r
2rz NO.OF ^y/ USE OF NEW. �A
CITY �-- I/PLANS
� O l BUILDING ! ll1/� /
STATEN TEL. LEGAL T 'p fa? i VV//Ca LIC. NO. 1 NO. OP BLOCS. �y LEGAL
(+/1 / / a�(
SIZE /C I / fi/ / NoW oN Lot '°j_ A.P.NO. 1 /b CO y -d Q
OF LOT ! ! d
USE OF /.. �j YARDS EVES
EXISTING BLDG. ( 4- d-C' APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST.) /
CENTER OF STREET REAR YARD
2 I 0 FRONT AG-'- -JL1J/ IN.
SIDE YARD I LEFT I RIGHT 3, R.SIDE <FT. IN.
DESCRIPTION OF WORK •
L.SIDE 3 3 FT. IN.
NE' 1 //I-ALTERATION I II ADDITION I IVII REAR tI'dIQ FT. ,6.0.d IN.
REPAIR I II MOVING I IIDEMOLISHI APPROVED �/( I�
DATE
A C �/ 0 '/,t
SB
BUILDING/al a Z- NO. OFROOMS / STORIES / y'/1 �j
EXTERIOR a4 !/ ROOF
COVERING (COVERING gag / / _ _
USE OF BUILDING AND WORK TO BE PERFORMErf
A Edi�i�.
F 'ffh �+ 22 a647,7 , ' P .
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 OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING
BUILDING CONSTRUCTION. VALUATION ,, // Le--
SIGNATURE OF ' 4 PERMIT FEE $�L
PERMITTEE .C`I ��`� / 0°_.....-- n
; $/ iOPLAN CHECK $ F
AUTHORIZED AGENT ///YYY///"'777 TOTAL FEE $ o
IL
OWNER SQUIRE) ALMA S. DATE 6-6-6o
JOB ADDRESS 1821 Viola Place BUILDING PERMIT NO. 12166
GENERAL CONTRACTOR owner VALUE $ 660.00
AP.No116-092-08 LOT 1 TRACT 1148 FIRE ZONE DESCRIPTION OF WORK garage
r ECTIONS DATE GROUP I TYPE V ZONE RIF
.ground Soil U.G. Water SUBCONTRACTOR PERMITS ISSUED
Underground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating _
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole
Underground Power
Rough Wiring
Trenches Forms Steel S, ,o— _ A
Floor System
Steel Reinforce Chimney Re•Rod
Bond Beam
Sheathing /3 I A/7 c-w 6 - >1- 6s
A
le and Flashing ct—G— 1/ — 6 0
In Out
Plaster, brown coat
Plumbing Fixtures, Final
Electric Fixtures, Final
Building, Final / 6a
OCCUPANCY
Form 210-5M-11-59 S-B P 12166
OWNER SQUIRE, F. S. DATE 5-15-58 _
JOB ADDRESS 1821_Viola Place BUILDING PERMIT NO. 6761
GENERAL ONTRACTOR Owner-Builder VALUE $ 28.00
LOT TRACT FIRE ZONE DESCRIPTION OF WORK Fence
JP J TYPE V ZONE R PLAN NO. 6 6
INSPECTIONS DATE PERMITS ISSUED
SUBCONTRACTOR DATE NUMBER
Trenches Forms Steel
Floor System •
Steel Reinforce Chimney Re-Rod Min , i/
Bond Beam MI ir
Frame and Flashing - .i�
Lathing, In Out 11111.1r,.." /
Plaster, brown coat WW2
Underground soil W/G Pipe Test a•
-Top OutOLS
Furnace 1 4.
Gas Vents -��a
Rough Plumbing
Cesspool Septic Tank iffnagaillMa
Prop. Swr. Line House Con. St. Swr. --m7WCMEM
Sprinkling System n Ela
'ng Final �jlaadall-
inn Fixtures, Final
L....1 Gas Test r'
onstruction Pole /
Underground Power
Rough Wiring - -
Fixtures, Final \
•'OCCUPANCY I O 1
Form 210-5M-1-59 - 676b
COSTA MESA BUILDING DEPARTMENT ! •
P. O. BOX 317 - 6764
COSTA MESA CALIFORNIA 0
mss` FOR APPLICANT T• fTLL It
C.L. OF STREET� =I a M
we BUILDING ADD'ESS __—,.
�iPROP LINE "'1 W v Owner ._ �/ j
- - -- T - - 12 FT. 61WroA v / 6
IO FT" FOR 60 FT. STREETIN, z "' Mail Addre -1
`50 FT. STREET • I ¢� o �+/
�I ,= City= c7.--t.
Ph. No���d y
U Contractor //I'® Ph. No.
Address
50 TIIF FROM City Lic. No. State Lic. No.
�n IOP PROP. — /
150 FT A m Size of Lot/0-XE° AP Nc�/� — (,%2- - `"-�
►- W cr
I- Setbacks: C/L Street "i n ) Rear • S
w I en
ct JI mu.
Side Yard - Right Left��� C%11
y r a p Type of Fence �/644 �•- � J ,
LL ALLEY QR PROP, LINE et aI p /
p.
F" "-- - - ', I I hereby acknowledge that I have read this application and state
-3 co a_ that the above is correct and agree to comply with all City Ord-
jVV rp I—.• inances and State Laws regulating building construction.
i \ I- APPROVED
1 APPROVED I SignaturePermi "" 4
r Ci"Y OF COSTA Mee I of Permittees / c
PLANNING DEQ T. FTI I Agent
37 6 IN.
SUB.ECT TO BLDG. DEPT. iEG,.
/L;. 1 �
FT. !' ��( 40 FOR OFFICE USE ONLY •
W 3 " BY DATE
Z PLAI TECH. _ _i... FT i Permit No.
'�` 76 y
a o
0L 60 FT ST. Received by Date Received Date Issued
Y I• i
I I l'I\ , 15 - /s-S3' /S--S-8
F,50 FT. ST. -a'I . t H t
tt — �iPROP._LINE t` I _ — — — _2 VALUATION Permit Fee $ ca ' °
p
I to
4. 6 " • -- Plan Check $
I C.L. OF STREETS V td i 11t, I $
TOTAL FEE $ a ' r7) -
MAXIMUM 4 FT FENCE MAY BE PLACED ON DOTTED LINES -- - ---
MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES USE REVERSE SIDE FOR DETAILS
• N Costa Mesa Building Department APPLICATION FOR PERMIT
`-4 — •� 111 EAST 20th STREET �0Sj BUILDING 7
-0'• COSTA MESA, CALIFORNIA
`f FOR OFFICE USE ONLY
• FOR APPLICANT TO FILL INReceipt No. Permit No.
Building /�•�/ n Q GIL� `
Address )J "pofe2 Cc(_, pj.�L/CJ,
Costa Mesa, CaliforI116 Received by Date Recd. ! at/I slued ,
Nearest / 1 .#1 r. — o —,i O dJ r
Cross Sta, tf( , Building
/ Allgicipini� Address
Owner - - �. / N.- Costa Mesa, California
Mail / i
Address kp_4,_-_10._ Zi ut I Nearest
Tel. Cross St.
City ,_,,, aA i . No. i:. ZoneNo.of Type Group
Architect or Lic. I Plans
Engineer No. - ' ' • 1 2- 2a
•ress / F— e ' .rms
I �/ City Lic. R. -saw -
ontractor i"J!i//7/i�' ,!. O. ;-, F' I Xi% IF - --
•
Address CITY OS
Lega Lot 'arEni ,:C PLAO?il�!C^'`,T 1 uM'')ES. r'
I
Description I No. • .,,, o.
(Attach Metes and Bounds) //� 07 a- o. r
No.of Bldgs. / ��
Size of Lot _ • 4 I Now on Lot / BY _�_ a (rr/ 0
Use of No.of . No.of -- xi
Existing Bldg. ? / I Families I Rooms
Setback Line from Rear Yard 10 I: �'-' k ).
Center of Street Si Side Yard n, • a LI Si a "." •. Z
D
DESCRIPTION OF WORK ':, ill L. Al li 7 t r' .; 0
r
New IA I Alteration I I Addition I -, ' l r au �-
RepairI I Moving I I Demolish I ;eallinfriffninn
t�rdy�
--
Building , No.of l
' e D?D .S- Rooms Stories
rior Wall /fig/ No 7 APPROVED c
-• ering _,/ , -_• I Roof
Covering ...mesa APPROVALS j
BuildingUse ew - Foundation Location Inspector Date
Forms,Materials,
eLa� _ �r .. .. ... Under-Pinning
/ /� j Frame: •Fire Stops,
Geerw - -- i Bracing,Bolts
I hereby acknowledge fat I have read this Application
and state that the above is correct and agree to comply 4, Lath.Int.
with all City Ordinances and Sta e Laws regulating :i Ql
building construction. Lath.Ext. •
Signature ofd/ D d l
Permittee �I�AS�G1�'' a Plaster, Int.
Authorized Agt. 6 Plaster,Ext. Q..
H
Valuation Permit Fee $ da — Masonry Reinforced C*
a9, 4( 0 — " Plan Check$ Bond Beam •
cla
$ r ' Total _
`: Fee $ 5 FINAL C
FORM 204 S-BP 2M 6-55 ,
0
OWNER SOUIRE.-FLOYD &--ALMA DATE 12-12-56
JOB ADDRESS 1821 Viola-Place - BUILDING PERMIT NO. #11091
GENERAL CONTRACTOR Chas. M. Sutterfield VALUE $ 8 6. 00
AP116-092-08 �"
LOT 1 BLOCK TRACT 11118 Dup. & slab for ftr. Carpo=
GROUP I TYPE V ZONE lilt FIRE DISTRICT 11081
PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench ,. x,, _ /-.2...4-5-7
Foundation Forms and'Grade to Garage -
Rough Framing ��tt
Plumbing, Rough to Slabs°I' ^ 1 �' 1"S . Hi ���u-$grl` f m3-.. 7/.SY
I
Plumbing, Rough Complete � C.,5 A-.,d r7
. Temporary Pole
Wiring, Rough FEB . 7 1957 V l Wm. .. (3a-.c% r _ 4_ - 1 3`Jb'4,--.)"' S/0 4 [.,,—
Heating, Rough Al Lo i 3-].6-17 MEW . p.,i /- 7G `5-7 —
Heating, Final MM L/-25-57
L ,,p� ll60wer, House Sewer,St.e/,4 4140x!._57 4 r},eus-, 1/7 44/3---3-7p /a 2 "-
Septic Tank or Cesspool
Lathing, InX 'Out)( 14- 4 3vin.„!°
Plastering ,� �{� 4b'e S'7 _ -
Plumbing,Final,Fixtures Complete iMS iet.24'=bi //''�� AII
11 �y�
Plumbing,Final Gas Test/S-tr INNS -2 5 7 ; +, __r �I/ r J�//�/�_/
Wiring,Final APR 29 1 .,7 VCB JMa �.'`''-` �W l.tl�CJ
A'
Occupancy APR 2 1957 g
FORM 210 3M 10.55 - h091
• 4858 FEE RECEIVE ,1,- '
COSTA MESA BUILDING DEPARTMENT �� 0 -I 6 1
P.O. BOX 317 Fl ,ANCE DEPS.
COSTA MESA. CALIFORNIA
yy OF COSTR ME
FOR APPLICANT TO FILL IN APFCtgkCATION FOR PERMIT
N
ADILDIG/ 2.:0_,;,_6„_ r_e BUILDING
ADDRESS /
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY 44,2)1
/�/,JQ�.J/}�//alp////J//�/J/,.� ` n� RECEIPT NO PERM T NO.
OWNMAIL 'L `tee. V (_24.. c.Ql. .J.✓ l.� C�
Sit �/q // tip V' BY /D,fT{RECE 'E''OJJ JJOf I55
ADDRESS�//ySit / 7C...N � A/ pi(t 1 (�'y�/� / '7"� //O/I.5 ; ;6 47
CITYe� �Q� TN O.M_g"/T/w ADD EISSG /IOL/� V ,r0 2A Z
ARC' 'CT LIC.
OR IEER �G 4J —-cNO. Ai — COSTA MESA. CALIFORNIA
/V FIRE
ADDRESS " ZONE
ZONE NO.OF TYPEGROUP
C.---)L-0CITY LIG � ,A.-,..,,A.-,.., /,(�� PLANS
CONTRACTOR �•�^. �'�, NO, d(/t�.J �
•
Ir� I'I D+ LI. ?^ TEL. APPROVED 4(....5...--' I /(J ,37
ADDRESS NO. BY DATE
LEGAL Iwr /
DESCRIPTION NO. /I 7 ff BLOCK TRACT CORRECTIONS
'
•
A.P.NO. 9Z - 1
SIZEFLOT/f(�/O2�ff X1 v/�` NO.OF BLDGS. t
O (� NOW ON LOT j
USE OF
EXISTING BLDG.
SETBACK
OF LINE FROM /0o / REAR YARD ,I7 '
CS
S4RFiYARO- RIGHT 2, 0 LEFT s 1 �ix� vIn
DESCRIPTION OF WORK .fl " Si
•c
� •-.:
NEV GI ALTERATION ADDITION PLANNING DEPT.
SUOJEC1 it)
t}/ �bLDG. DEPT. REG.
REPAIR MOVING DEMOLISH '�zy�
BUILDING /, y NO.OF
SIZE � ry-X �� ROOMS STORIES 3y D/.T
EXTERIOR WAyyL/ //''''� Q ROOF I R4•"' I•CH.
COVERING64.LLLt.0 Ij N t COVERING
USE OF NEW "�,�// / /��'////// L -[/
BUILDING / Yvt n y 4J p� r f4,_37)
Io
STATEBY ACK girt)E THAT T E READ THIS APPLICATIONLYW' AND
ITYTHAT IN N ABOVE CORRECTWSAND AGREE COMPLY WITH ALL
CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CON$TRVC.
norv. VALUATION CO PERMIT FEE S O • 0 6
SIGNATURE 0:1÷7 �_
PERMITTEE .• / D
J PLAN CHECK $ �I DO
AUTHORIZED AGENT $ " TOTAL FEE S /2/ 00 `fib
JUL 9 1958
OWNER SQUIRE, FLGYD &-ALMA DATE 4-I0-57
OCT 2 81958
JOB ADDRESS 1821--Viola Place BUILDING PERMIT NO. #4824
GENERAL CONTRACTOR Owner Bldr, VALUE $ 1,740.00
&Pll6-o92-8
1148 BLOCK TRACT I Garage; Workshop AS PER U.B.C.
GROUP J TYPE V ZONE Rh FIRE DISTRICT 4858
' PERMITS ISSUED
INSPECTIONS DATE SUBCONTRACTOR
DATE NUMBER
Footing Trench , .- -
Foundation Forms and Grade to Gar..e
Rough Framing 4011! V. . /S"
Plumbing, Rough to Slab > rf/-3 r-
Plumbing, Rough Complete Myr q_,)-sem ......AilatPleat „ / 9 —3-,r7 //O,3, ,-
Temporary
Temporary Pole _ �
Wiring, Rough �..�� ri
- - F.f4,rv)t.led -7-/7-S-7 9'VO y' `-
Heating,Rough
Heating,Final .h..t"D''d^r. - ff 4 -j'
Sewer, House Sewer,St. oi
Sentic Tank or CessPoolj .� LFA RI to
I ig, In, a' Out__"" 11, - 21,-r/J '
Plastering _ •
Plumbing,Final,Fixtures Complete4 f$ .2--2.3.- , ,
-Plumbing,Final Gas Test-ne--j#.
Wiring,Final - 7T '---41(,1
Occupancy /frW5 /1-3 6.
- -
FORM 210 3M 10.53 4824